OET SPEAKING FOR NURSES

Simplified to get grade A/B

SHAMINI MARY

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 Copyright © 2021 Shamini M ary

All rights reserved

The characters and events portrayed in this book are fictitious. Any similarity to real persons, living or dead, is coincidental and not
intended by the author.

No part of this book may be reproduced, or stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without express written permission of the publisher.

ISBN-13: 9781234567890
ISBN-10: 1477123456

Cover design by: Art Painter

Library of Congress Control Number: 2018675309
Printed in the United States of America

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 CONTENTS
Acknowledgments I
1 Basic Rules. 3
2 Ways and Methods to Prepare 12
3 Overcoming Mother Tongue Influence. 24
4 Using Idioms/Phrases, Fillers and Questioning Skills. 29
5 Ways to Frame Sentences, Avoiding Grammatical Errors 42
6 Building Confidence and Avoiding Stammering. 50
7 Technical Knowledge, Lack of it, and how to Handle it. 57
8 Handling situations diplomatically and ways to do it. 62
9 Practice questions for Roleplay and Sample Conversations 71
10 General Etiquettes 189
11 Last-Minute Tips. 192
12. Glossary 199

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 ACKNOWLEDGMENTS

I thank every single nurse whom I have trained over the years, for giving me
splendid experiences which have led to this book. My hearty thanks to
Dr.Yogesh Ashokkumar and Dr.Priyadarshini Ponvannan for helping me with
the medical terminologies. My heartfelt gratitude to DhanvarshaP.J for
assisting me through the book.

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 1 BASIC RULES
For anyone who reads this, I suppose you are preparing for your OET exam or
working on improvising your communication skills. In this book, I will be sharing
basic insights, starting right from the challenges encountered during preparation as
a beginner, and then we'll move on to roleplay scenarios and sample
conversations. After a brief description of the preparation techniques, and basic
rules for OET scoring.

OET is an exam where you will have your speaking test for 20 minutes. The scoring will be in
bands. It will be up to nine bands. The pattern of questions will be a roleplay.

You will be having two roleplays, where there will be a conversation between a nurse and the
patient. The scenarios will be given on a card. The scenario, patient's health condition, and how it
will progress will be mentioned in the question. You will be having two role plays in the role of your
profession, where you will be the nurse and you will be speaking to a patient.

Before the session starts you might have five minutes approximately for a short
conversation, to break the ice with the examiner and get comfortable. The conversation will be
mostly about your professional background. This will not contribute to your score.

Approximately there will be around 20 exchanges of responses between you and your examiner. This is
not specific to time because this might vary depending upon your speed, length of your content, and
exchanges between you and the examiner. You will have three minutes of preparation time after the
question is given to you. You can write hints on the card within three minutes of preparation time.
So, once the question is given to you write hints and ask if you have any doubts about the question.

The role play will be based on the workplace situation which will be your
hospital setting. Do just like how it happens in your day-to-day work, for different
departments in a hospital.

TOTAL SPEAKING TIME- 20 Minutes (approximately)

4-5 minutes – casual ice-breaking conversation with the examiner (does not
contribute to scoring)
3- minutes preparation time for each roleplay * 2 – 6 minutes
5- minutes – roleplay each * 2 – 10 minutes

Scoring

How will your score be valued:-

The test is recorded to assess your scoring. So, right from the time you start your test, your
conversation will be recorded. It might also be played for further evaluation, by any external examiner.

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 How you speak matters because everything gets recorded and it can be played
and observed. Your scoring will be judged specifically, not on a general basis.
There are a lot of criteria that will decide your score. Focus on how you respond
to the task as how you handle the situation matters. Specific assessment criteria
that meet the demand of communication in health centers are required.

That means you need to fulfill the demands of what is expected in a workplace. You need to justify
that you will be able to handle a situation that is given to you.

This is a language exam, not a test to prove professional knowledge. Even

if you are lacking any details in terms of profession
1. your language
2. your ability to handle the situation efficiently

are all that matters to determine your score.

Pay attention to the details in the question where the case of the patient
is mentioned in terms of the diseases and health history or complaints.

Only if you pay attention to the details during your preparation time, you will
be able to think and analyze what might be the common questions that might arise
in the scenario. Therefore you will be able to prepare where and what you need to
convey and how to answer the questions that might arise.

Coming to criteria that you will be judged for and areas you need to work on.
There are several aspects where you need to focus and work to improvise your
skills.
This includes

Pronunciation,
Accent,
Fluency,
Clarity,
Grammar,
Building a relationship with your patient,
Understanding the situation and the mindset of the patient,
Handling the patient efficiently.

To handle all these in a better way, be attentive to the details which are mentioned in the question
given. You need to organize the content that you are going to deliver. So that you can do your speaking in a
better way.

Why is this test difficult?

OET roleplays are mostly difficult for Indian nurses for a few reasons that I

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have listed here based on my experiences.

The experience or exposure that Indian nurses have is very limited to one
particular department where they work throughout their career. Even if there is a
job change or role change, most of the time they are likely to work and practice in
one department only.

When there are case scenarios that involve several departments with cases of
adverse diseases or situations, there might be confident issues that might arise
simply because you have not worked and had exposure in that particular
department.

Another drawback is that the work of Indian nurses is limited to practical

administrations mostly. Due to which the use of communication skills is very less.

However, one thing which goes forgotten is that

This is not an exam where you are judged for your content or professional
knowledge and qualification.

Most of the OET materials only focus on roleplay scenarios and questions.
However, for a beginner who has trouble with speaking, preparing to speak
continuously/fluently might not be sufficient.

How to start the conversation. How to go about it in terms of practicing all the
needed criteria. How to ensure that you are getting a good hold in terms of
pronunciation, accent, fluency, grammar, etc. all these matters.

Working right from the basics:-

This is one more place where many lack knowledge when you start preparing for your OET speaking.

The starting point of preparation which most do is directly jumping into the roleplay scenarios. Where
you see a question and then think how to speak what all questions will be asked and then prepare how and
what all you need to convey.

This method of preparation will not be effective when it comes to OET

speaking. When there are a lot of other areas which you need to work on and see if
you are strong and stable.

If your grammar is weak.

If you are not comfortable with framing sentences,
If you are not fluent enough,
If your accent is not good,
If your conversation is not clear enough with your pronunciation and sentences as

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 such.

Jumping into the role play and practicing it will not be helpful in terms of the
score for your examination.

The main aim of this book is to start with the basics of how to prepare and get
strong with the foundation in terms of your language and then dive into your
roleplay scenarios. Seeing every challenge which most of you would encounter
with efficient tricks and techniques.

Another reason why this exam would be difficult for nurses is that: Majority of
the scenarios which are mentioned in the roleplay are handled by duty doctors in
India. Where the work of nurses would mostly be limited to practical
administrations. This is another reason to cause difficulty in terms of handling and
getting comfortable with conversations.

Also that, none of the hospitals are particular that the mode of language for
communication with patients should be only in English.

The work of the nurses goes limited to practical administrations where

conversations with the patients are also very limited. Being not specific to
language as well, due to which English is not widely used at the workplace or
with colleagues. This makes the task more difficult. Because the way scenarios
are handled varies from the roleplay scenarios to the day-to-day life scenarios.

KEY TAKEAWAYS

OET speaking test is for 20 minutes and the scoring will be in bands. It will be up to nine
bands. The question type will be a roleplay.
There will be 2 roleplay conversations between a nurse and a patient. The scenarios will be
given on a card.
The scenario, patient's health condition, and how it will progress will be mentioned in the
question.
Before the session starts you might have 5 minutes approximately for a short conversation,
to break the ice with the examiner and get comfortable.
There will be three minutes of preparation time after the question is given to you.
You can write hints on the card, within the three minutes of preparation time.
TOTAL SPEAKING TIME- 20 Minutes (approximately)

4-5 minutes – casual ice-breaking conversation with the examiner

(does not contribute to scoring)
3- minutes preparation time for each roleplay * 2 – 6 minutes
5- minutes – roleplay each * 2 – 10 minutes
Justify that you will be able to handle the situation that is given to you.

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 This is a language exam, not a test to prove professional knowledge. Even if you are lacking
any details in terms of profession, your language and your ability to handle the situation efficiently
are all that matter to determine your score.
Pay attention to the details in the question where the case of the patient is mentioned in terms
of the diseases and health history or complaints.
Focus and work to improve the following skills:-

Pronunciation,
Accent,
Fluency,
Clarity,
Grammar,
Building a relationship with your patient,
Understanding the situation and the mindset of the patient and
Handling the patient efficiently.

This is not an exam where you are judged for your content or your professional knowledge
and qualification.

See if you are strong and stable in the following areas and work on it:-

Grammar.
Comfort with framing sentences.
Fluency while talking.
Accent.
The clarity in conversation regarding your pronunciation and sentences as such.

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 2 WAYS TO PREPARE
There are several ways to prepare for every exam. Here I have listed a few
basic techniques which will be easy to practice and get more familiar in your
foundation with the language.

JAM – Just A Minute

The first technique is JAM, which is also called Just a minute. It is a common
game that is used and played by many. Every day you can just think or just read
one common scenario of roleplay. Take a minute to think what will be the common
questions that you will be encountering from the patient’s view. Just randomly
after thinking for a minute and preparing, try to speak on it.

You can also try to rehearse each conversation by imagining that there is a
patient and you need to speak to them imagining the questions. Do roleplays of
both roles. Say you frame a question that will be commonly asked by the patient
and then you think of a response and you respond to it. If you have someone, a
friend, or a colleague close by, you can give the scenario to them. Take time to
think what will be the similar questions they will be asking you and just practice a
roleplay scenario with them. Within a minute, you can also think of the possible
title sentences or fillers that you will use.

Say for instance,

Hi, good morning. I'm the nurse on duty today how may I help you?
How are you feeling today?
I hope you are feeling good after your last visit.
May I know what is the concern that brings you here?

These are a few common statements that you can use to start a conversation.

Likewise, with practice, you will be getting comfortable with using different fillers and using different
types of statements like these. These might be useful for you amidst conversations.

➢ Because when you use these, you will have the time to think and frame your next sentence.
➢ You will have the time to think and frame what content you will be speaking.
➢ This will also reduce the number of mistakes that you will commit during your conversations
because once you get comfortable with these and frame them in the right way, you are less likely
to create grammatical mistakes or errors.

Once you start using fillers, idioms, and phrases and get comfortable with
using them. You can also frame common questions that you can ask the patient.

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 For example:

How have you been feeling for the last two days?
On a scale of 10, May I know how would you rate your pain?
What are the medications that you are taking at the moment?
Are you having any other health complications?

These are common types of questions that you can ask. Irrespective of
whatever department the roleplay scenarios are from.

Once you get a hang of common questions like these. Within a minute, you can
make a list and then speak all the types of questions that you can ask.

On another day, take a roleplay scenario and make a list of all the fillers or
idioms that you will ask or speak to the patient.

Once you get used to this, it will help you in getting comfortable giving
appropriate responses in the conversations, and frame questions effortlessly.

Meanwhile, you can also take time to frame your sentences about the content.

The next parameter is getting comfortable responding to harsh and short-

tempered patients in roleplay conversations.

You may tend to get more stressed on delivering the content or lose control of
the conversation when your patient (i.e your examiner), or whoever you are
speaking to, starts being a little uncooperative with you. By becoming harsh and
not responding to you properly.

Getting comfortable with scenarios like these is a must when you practice
speaking. As you need to be more comfortable, to prove your efficiency in
handling a situation like this.

While handling heated conversations and harsh patients, you can still be
diplomatic and use fillers here too.

I'm so sorry to hear that.

I'm sorry for the trouble.
Can you please / could you please - give me a moment, I'll do my best to rectify this.
Please do not worry, you are in the best hands.
I ensure you that your concern will be addressed.
Please give me a moment, ill do my best for you.
I'm so sorry to hear that. I apologize.
I wish I could do much better. However, I am not authorized to do so.

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 These are a few common statements. These can be used irrespective of what
the roleplay scenario is and what the situation is. However, you will only get
comfortable when using these in practice.

One more key hint, which will help you here is to think from the mind of your
patient.

How they will feel from their mind, in the scenario from what you have
seen.

Thinking from the patient's perspective and understanding how they will feel
and respond, will give you more hints during your preparation time.

As a result, you will be prepared to respond and deal with how they feel. You
will also be prepared to assure them and make them feel comfortable enough.

You can also recollect scenarios that you have seen in real-life experiences.
Think about how you responded there or rethink how you can respond better to the
same situation.

Observing your day-to-day scenarios at work will also be helpful here. You
can also make a list of common statements, that you can use to calm someone who
is out of temper. To calm someone who is very harsh at you or un-cooperative.

When you make a list of common replies and statements that you can use.

Example,

I'm so sorry to hear that, I will do my best to tackle what is concerning you.
etc.

If you are going out of the scenario

If you're not able to respond
If you don't know what to respond to

you can use these which will be helpful to you.

RECORDING AND HEARING

The second technique to prepare is by recording and hearing it. Generally, one
main challenge with speaking is that: you need to focus on a lot of aspects like
grammar, sentence formation, vocabulary, etc. at the same time. whereas you don't
have time, as much as you do in your writing or other sections.

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 When you are writing, you can take time to think for a moment, and then write
and read the same sentence and see if it is correct. However, in speaking, you
don't have that facility.

You need to think to frame your sentences, at the same time you also need to
focus on your grammar, punctuation, fluency, etc.

When you record what you speak.

Say, for instance, imagine a roleplay scenario.

You can think about the question in your mind or read the question aloud.
Think about the possible questions that will be asked by the patient to you and you
can speak the responses too.
You can also read the patient’s side conversation question from the sample
roleplays and give your answers.

When you do something like this, record it and listen. You will be able to
identify most of the mistakes that you commit. At least in terms of how you frame
your sentences, grammatical mistakes, and the way you pronounce words. You
will be able to focus on your vocabulary accent, etc.

Every time you record and play, you can make a list of the mistakes that you commit and the
areas you need to work on.

You can compare it every day or probably after a few weeks of practice again. Comparing and
checking if the same mistakes are repeated can help you improve.

When you hear the recorded mistakes, you can eliminate pauses also with
Practice.

Even if you have many pauses, with the practice of every day in a month or
more, definitely your pauses and stammering will reduce.

You can also focus on the sentence formations so that, usage of vocabulary and
fillers can be trialed. When you play it and hear you will have an idea of the
mistakes you're committing and the areas you need to improve.

Grammatical mistakes can still come

despite using fillers, or idioms.

Because basic grammar will vary, even if the sentences are a little bit changed
or rephrased. This is why practicing and getting comfortable with using them is
important.

PRACTISE FROM WORK

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 Another way of practice is starting to practice from work. If you are someone
who is working, you can speak to your colleagues in English. Please don't be
hesitant to do this because you are learning. So irrespective of whether you
commit mistakes or not, don't let it hinder your self-confidence.

You can speak to your colleagues or people at work in English. You can also
rehearse scenarios with patients where you can respond to the patients
professionally. You can see what are the questions, patients ask you and try
responding formally to them.

By doing all these, you can understand where you lack in terms of your
language.

You can also analyze what kind of scenarios are difficult for you to handle
with practice when you listen to them. When you observe real-life scenarios and
incidents, you will be able to make a note of what kind of scenarios are difficult
for you to handle.

If you're not comfortable with one or two departments specifically. Say, for
instance, you have worked in a cardiac ICU or dialysis room model and if you
have any specific department where you're not very comfortable about handling.
Eg. Gastroenterology clinic cases, suburban clinic cases, accidental trauma cases,
etc. You can give more focus to it during practice.

You can also speak to colleagues or friends from different departments to gain knowledge and
ideas from different setups in terms of professional knowledge. So that once you are comfortable with
it, you will also be confident enough to face different roleplay scenarios.

You can also connect with your senior colleagues to know how they spoke
or handled different circumstances and different ways of how you can
respond to scenarios like that.

Responding in the mind by seeing sample questions.

You can read the roleplay scenario, read the sample question, and then try
responding aloud to it by framing your sentences. You can record this and listen to
it.

Read the sample questions and think what can be the possible responses that you can give. Write down
a list of common responses that you can use for different conversations. (seeing these common questions
before the exam might be helpful)

Recalling the possible questions from the patient in the preparation time can
be helpful.

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 During the preparation time when you think what can be the possible
questions that a patient can come up with. You can also frame answers for
harsh or possible difficult questions which can be asked by the patient.

By doing this you can get comfortable with handling and responding to tough
situations and harsh patients.

You can see possible answers to handle situations like these and make a list of
them to practice.

In that way, if you find the scenario very difficult. You can use something
from that list to help you handle the scenario better.

Start using common phrases wherever possible. Such that, it will reduce
grammatical mistakes and also give you time to think when you are not very
comfortable about handling a scenario.

KEY TAKEAWAYS

Start using fillers, idioms, and phrases and get comfortable using them.
Think from the mind of your patient, how they will feel in that scenario.
Think about the question in mind or read aloud the question and give responses.
Read the patient’s conversation side question from sample roleplay and give your answers.
You can make a list of the mistakes that you commit and areas you need to work on.
Compare and check if the same mistakes are repeated or you have improved in those.
When you hear the recorded mistakes, you can eliminate pauses also with Practice.
Grammatical mistakes can still come despite using fillers, or idioms. Because basic grammar
might vary, even if the sentences are a little bit changed or rephrased.
Speak to colleagues or friends from different departments to gain knowledge and ideas of
different setups in terms of professional knowledge to handle different departments.
Connect with your senior colleagues to know how they spoke or handled different harsh
circumstances and ways of how you can respond to scenarios like that.
During the preparation time, think what can be the possible questions that a patient can
come up with. You can also frame answers for harsh or possible difficult questions that can be
asked by the patient.
If you find the scenario very difficult. You can use something from the list which you have
made to help you handle the scenario better.
Start using common phrases wherever possible, it will reduce grammatical mistakes and also
give you time to think when you are not very comfortable about handling a scenario.

3. overcoming mother tongue influence.

Mother tongue influence is another common problem, which many encounter.
Because every person's pronunciation varies depending upon their habitual
environment.

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 Mother tongue influence is nothing but pronouncing words differently than how
they should be. Due to this, pronunciation varies. This might cause trouble in the
clarity of how you deliver your content.

The way to overcome this is only with practice. Sometimes you might know
the right way to pronounce, even though you might have mother tongue influence.
You may still commit the same mistake because you are used to it as a habit.

Say, you know the correct pronunciation for that word, but still, you try to
pronounce it in the same old way. This can be because of habit. The only way to
overcome this is with practice.

You can use voice recognition to check if you're pronouncing it the right way because if it gets
recognized you can ensure that you're pronouncing it the right way if it doesn't get recognized. You can
probably think that it is getting recognized the wrong way.

There are different modes of voice recognition that are available in almost all
phones. Where you speak something and then it types what you speak to text. You
can try doing this to check and see if you are pronouncing the right way.

You can start noticing words when someone talks.

You can watch YouTube videos where you observe people speaking and their
pronunciation. To learn what are the different ways of pronunciation, and compare
them with yours.

LISTEN AND WRITE SUMMARY

Another way to practice this is by listening to BBC News or any English news
preferably. Most people with mother tongue influence have difficulty in
understanding advanced English speeches.

The difficulty to contemplate what content is conveyed can be overcome in

this way.

You can hear, 10 to 20 minutes of news English news every day and try
writing a summary of a paragraph of what you heard in the news. Only when you
understand the information conveyed you will be able to write a summary of it.

This will also help you to improve your understanding of the language and in
turn, it'll also be helpful for your listening and writing sections.

In the beginning, after watching 10-20 minutes of news try to write a summary
of the information conveyed. Initially, even if you write very less, what you

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understand, will increase with time.

MOVIES WITHOUT SUBTITLES – trying to follow conversations

Another common way to prepare is by watching English movies without

subtitles, this can be an entertainer too. If it is very difficult for you to follow, you
can start with simple English movies like animation movies. It will be easy for
you to follow, even without subtitles.

Once you get comfortable with that. Later you can watch other movies where
English is more complex or too fast.

Usually, animation movies are easier to follow as the English used is simple,
and slow because it is made for children to understand. It's a matter of practice
too, to start following what is spoken effortlessly without subtitles. This will
eventually create more understanding.

People with mother tongue influence, don't pronounce all words with mother
tongue influence. Only some words have more mother tongue influence. You might
pronounce most words correctly. The common words which you have used over a
while.

You can record and listen to identify the words which you are having a mother tongue influence.

Once you notice and find out the words which you have an influence on. You
can try working on it and pronouncing it the right way. Check it in voice
recognition to see if you have corrected your pronunciation.

Whatever words you are having a moderate influence on, by using it more in
conversations in the right way, you can get rid of mother tongue influence.

You can also start listening and noticing the pronunciation of different words
and compare them to yours. When you speak, when you listen to someone
speaking, and then you see the pronunciation. Compare the pronunciation with
yours, and see if you're pronouncing it differently or if it is done in the right way.

By following these insights, you can get rid of mother tongue influence easily.

KEY TAKEAWAYS

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 You can use voice recognition to check if you're pronouncing the right way, if it gets
recognized you can ensure that you're pronouncing it the right way if it doesn't get recognized,
you can probably think that it is getting recognized in the wrong way.
Watch movies without subtitles – try to follow conversations.
You can record and work on noticing what are the words which you are having mother
tongue influence.
Start listening and noticing the pronunciation of different words and compare them to yours.
When you speak, when you listen to someone speaking, you see the pronunciation. Compare
the pronunciation with yours, and see if you're pronouncing it differently or if it is done in the
right way.

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 4 USAGES OF IDIOMS/PHRASES AND FILLERS
There are different types of questions that you can ask a patient based on the reason why it is asked.
There are two major types of questions that you can ask a patient,

open
closed.

Generally, questions are asked to help the patient find out what they believe to be their problem and how
it affects their day-to-day lifestyle.

Open questions give chance to explore the question into different sub-questions.

Say for example,

You ask a patient, could you tell me more about your headache?
Depending upon the patient's reply or understanding about the headache, there might be more prompts,
which are helpful for you to ask a few more questions. This is an open-ended question.

These are asked to have a deeper understanding of the patient's problem.

The second type of question is closed questions. Closed questions are questions where the patient
would usually give a yes or no reply.

For example,

Nurse: Are you taking any other medication?

Patient: Yes.
Nurse: when did you last take these medicines?

In these questions, the patient's response might be restricted to Yes or no? Or a few words.

Sometimes, these questions might progress further depending upon the reply of the patient.

Example:
Nurse: Do you get dizziness when you bend down or do any active movement?

If the answer to this question is yes, then you can explore further by asking a few more questions related
to this.

The third type of question is specific or focused questions. Focused questions allow you to gain
specific information about the patient. It breaks down the question to a specific subject by narrowing it
down.

Example:

Nurse: What can I do for you today? open question.

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 Patient: I've tried the medications but still need some help. A focused response that can help you to
elaborate

Nurse: Tell me what are the prescribed medications that you have taken so far? A focused question
that helps to gain further information.

Patient: I've taken all the medications that I was prescribed on my last visit.

Nurse: Would you like to elaborate on your concern about what is troubling you a little further? Closed
question to gain a yes or no answer.

Patient: Yes, please. Unhelpful question types.

Leading Questions that suggest the desired answer which is difficult for the patient to disagree with
might not be helpful.

For example, you don't wake up sneezing at night, do you?

This is likely to raise the “Oh no” response.

Whereas, when did you last have a sneeze? might allow the patient to elaborate further.

On the other hand, questions with multiple sub-questions might confuse the patient and might
not be helpful to you in exploring it further. It ends up confusing you as well.

Say for example, do you have any pain, swelling, or discomfort?

If the patient says Yes, you will need to break down the answer specific to the two sub-questions

If you do not understand what the patient is conveying, you can still ask them to explain it again. You can
frame a sentence by asking, could you please explain what do you mean by, (and repeat what they
said)

After you have completed a series of questions. You can do a recap of the patient's response history
by telling a summary of everything that they have conveyed so far and asking them if it is correct.

If you have covered everything. You can end the roleplay, by giving a final summary of whatever
you have covered so far.

Understanding the patient is a powerful thing, which is very important. The response of the nurse should
be framed in a way that conveys that they have understood the patient, their problem, and how they feel
about it.

So, to convey a response that also means that you have understood the problem can be done by using
empathy.

Empathy is a powerful skill, which can be used by you to acknowledge how the patient feels
emotionally.

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 You can do this by summarizing what they have conveyed from the patient's point of view and by
responding with empathy.

This can convey that you have understood the emotional state of the patient as well.

Say, for example,

Patient: I do want to stop consuming alcohol, but it is hard. I am having a tough time keeping up with
that.

Nurse: I can understand that you are worried about your health and well-being But I assure you that
you will be able to do it with a little bit of help.

Paraphrasing is another way of reframing, the sentence which the patient has conveyed.

Example Patient: I know that my alcohol consumption is affecting my health. And I can't afford it
anymore. However, it is affecting my lifestyle and my daily job, I need to stop, I am aware of that.

Nurse: I believe that you would like to give up alcohol with some help.

Different ways of questioning:

1. Tell me more about your headache?

2. Could you please tell me more about your headache?
3. Do you do any workouts or activities daily?
4. When did you last feel dizzy?
5. Are your periods regular?
6. How may I help you?
7. What can I do for you today?
8. Tell me, what are your diet patterns?
9. Would you like me to check your basic parameters if they are normal?
10. When did you last have an asthmatic attack?
11. Do you have any pain or swelling after a long walk?
12. Could you please explain how you are feeling and what symptoms you are experiencing?
13. Could you please explain the symptoms that you have had so far?
14. Where do you feel the pain?
15. Did you take any medication at home?
16. How did this happen?
17. When was the first time you experienced discomfort?
18. How long have you been having this complaint for?
19. Are you allergic to any kind of drug?
20. Do you have a history of any ongoing medical conditions?
21. Have you ever been hospitalized for any kind of complaint?
22. Have you had any surgeries so far?
23. Is anyone in your family suffering from the same condition as yours?
24. How has your appetite and weight been off late?
25. Do you mind answering a few more questions to get a better understanding of your
condition?

22
26. Do you mind, describing the symptoms that you are experiencing?
27. To have a clearer picture of what you are going through, I'm afraid I may need to ask a few
personal questions. Do you mind, can I proceed?

Empathetic statements.

28. I'm sorry about that.

29. I understand.
30. It must have been hard for you.
31. Do you please mind to tell how you have been feeling?
32. I appreciate it if you could tell me the symptoms that you are experiencing currently so that I
can understand the situation much better.
33. I can see that you are having a bad day. However, I would like to assure you that you are in
the best hands. And you will feel better.
34. I'm so sorry to hear that. So, you have been feeling, or having symptoms of…… is that
right?
35. I understand that you have been feeling ----------and having symptoms of ---------, I hope
I have heard you right.
36. In other words, I believe that you have been feeling ------- is that correct?
37. To put it in brief, I hope you feel -------- am I right?
38. To rephrase what you have said so far, You said that ------, could you please elaborate?

Ways to reframe a sentence of what the patient has conveyed.

39. It looks like

40. It seems that
41. I believe that
42. I hope I am right believing that
43. I completely understand that.
44. I hope your concerns are
45. I can see that

Ways to start a sentence to give advice.

46. It is important for you to

47. It is necessary for you to
48. It is recommended that you try
49. It is imperative that you
50. In cases like these,
51. I suggest that
52. I advise that
53. I would like to recommend
54. You must follow the advice of ------ for the well-being of your health.
55. It would be helpful if you

23
56. I'm afraid that this might.
57. I'm afraid that you need to.
58. It is essential that you
59. I strongly recommend or advise you to
60. I'm sorry this might not be something you are comfortable with.
61. I would like to help you in working with this together.

Statements for assuring patients.

62. There is no need for you to fear, you are in the best hands.
63. You are under-qualified professionals. Please do not worry.
64. There is no need for you to be alarmed.
65. I'm afraid that there is no better option available than this.
66. This is the best possible option that is available as of now.
67. I can assure you that we are here to help you.
68. I assure you that there is nothing to worry about.
69. I urge you to relax, as stress might affect your emotional and mental health too.

Statements that can be used to convince patients regarding different case scenarios.

70. I believe that this is the best option available at the moment.
71. For this reason, you need to-----. If not, you might have adverse effects and your health
might deteriorate.
72. I'm afraid this might delay your recovery.
73. I hope you understand why it is important for you to do this.
74. If you do not make the right changes, it might affect your recovery.
75. I suggest you to follow the prescribed medical advice to prevent your health from getting
deteriorated.

Phrases you can use.

76. To recap, from what I have understood,

77. It seems that………… am I right.
78. So, I understand that………. Is that correct,
79. Just to recap what we have discussed,
80. What we have discussed so far to backtrack,
81. What we have discussed so far.
82. I understand that you have been feeling --------and having symptoms of ……………….
am I correct?

Conversation starters:

83. May I know what brings you here today?

84. May I know what has bought you here today?

24
85. May I know what seems to be the problem or trouble that you are undergoing?
86. How may I assist you today?
87. May I know what seems to be bothering you?
88. Can you please tell me why you have come here today?
89. Can you please tell me what are you concerned about?
90. Can you please tell me? What are you worried about?
91. Could you please share, what are the difficulties that you are undergoing?
92. Can you tell me what is the problem that you have regarding this?
93. May I know what brings you here today?
94. Can you tell me about the symptoms that you are experiencing?
95. Hi, I am the nurse on duty today may I know what is your concern?

KEY TAKEAWAYS

There are two major types of questions that you can ask a patient – open and closed.
Open questions give chance to explore the question into different sub-questions.
Closed questions are questions where the patient would usually give a yes or no reply.
Focused questions allow you to gain specific information about the patient. It breaks down
the question to a specific subject by narrowing it down.
A focused question can help you to elaborate.
A focused question helps you to gain further information.
Questions with multiple sub-questions might confuse the patient and might not be helpful in
exploring it further. It ends up confusing you as well.
If you do not understand what the patient is conveying, you can still ask them to explain it
again. You can frame a sentence by asking, could you please explain what do you mean by-----
------- and (repeat what they said).
Tell a recap of the patient's response history by telling a summary of everything that they
have conveyed so far and asking them if it is correct.
If you have covered everything. You can end the roleplay, by giving a final summary of
whatever you have covered so far.
Empathy is a powerful skill, which can be used to acknowledge how the patient feels
emotionally.
Empathy can be expressed by summarizing what they have conveyed from the patient's
point of view and by responding with empathy. This can convey that you have understood the
emotional state of the patient as well.
Paraphrasing is another way of reframing, the sentence of whatever the patient has
conveyed.

25
 5. WAYS TO FRAME SENTENCES AVOIDING
GRAMMATICAL MISTAKES
These sentence structures can be practiced in your writing sections too. If you
get familiar with using them in writing, you will easily be able to use them in your
speaking section too to frame sentences.

SENTENCE STRUCTURE

A Sentence has 2 parts-

1. Subject –What the sentence is speaking about 2. Object-What is told about the subject.

Noun - Name of person, place, animals, or things/objects.

Verb -Any action word or a word that involves actions, Eg. Eat, play, writing, talk, walking Etc.
(is/are, was-were are also categorized as verbs)

Adverbs- day, month, year, time, week, today, tomorrow, yesterday, etc.

Types of adverbs.

1. Adverb of place – anything which refers to a place.

2. Adverb of time-anything which refers to a time.

3. Adverb of manner-anything which refers to a manner or quality. (They usually end with ‘LY’)
E.g. Beautifully, quickly, happily.

Infinity

infinity= to +verb.

E.g., To play, to talk, to cook, Etc.

SIMPLE SENTENCES

1.Simple sentence-format (subject+verb+object)

Eg. The cat/is sitting/on the wall.

The cat - subject

is sitting - verb

26
 on the wall - object

2. Subject/verb/adverb

E.g. Raghu /is absent/today.

Raghu - subject

is absent - verb

today - adverb

3. Subject/verb/infinity

Eg. She /is going/to play.

She - subject

is going - verb

to play - infinity

4. Compound Sentence-Combine two simple sentences with a conjunction (and, or, but) in
between.

Simple sentence+ conjunction+simple sentence.

Eg. I ran fast/but/I missed the train.

I ran fast - Simple sentence

But - conjunction

I missed the train - Simple sentence

COMPLEX SENTENCE

1. Noun clause

Subject/+ verb/+ that/+ simple sentence

(use any one in the place of a verb- believe, suggest, think, argue, emphasis, urge)

Example:

1. I /believe/that /the climate is getting colder.

27
I - Subject

Believe that- Verb + that

the climate is getting colder - Simple sentence

2. Doctors/suggest/that/walking is good for health.

Doctors - Subject

Suggest that- Verb + that

Walking is good for health - Simple Sentence

3. Some/think/that/social media is also helpful despite its drawbacks.

Some – Subject

Think that – Verb + that

Social media is also helpful despite its drawbacks - Simple Sentence

2. Adverb clause

Use any of the below words between two simple sentences.

Simple sentence + (any word listed below) +simple sentence

(If, because, although, even though, as, when, though, whenever, whether)

Example:

1. He cleared the exam/although/the exam was very tough.

He cleared the exam -Simple Sentence

Although- Conjunction

The exam was very tough - Simple Sentence

2. I will go abroad/if/ I get my visa on time.

I will go abroad - Simple Sentence

If - Conjunction

28
 I get my visa on time- Simple Sentence

3. I was absent yesterday/because/ I had some personal work.

I was absent yesterday - Simple Sentence

Because - Conjunction

I had some personal work - Simple Sentence

3. Adjective clause

Describes the noun of a sentence using two words

1. which - Which is used when your noun is not a person.

2. who​- Who is used when your noun is a person

Note: A sentence may have two or more nouns, always describe the first noun.

Example:

1. Education which is very important/should be given to all.

Education – Subject (not a person -so described using which)

2. Fruits which are good for health/should be consumed by all.

Fruits - Subject (not a person -so described using which)

3. Children who are underprivileged/deserve free education.

Children – Subject (person -so described using who)

KEY TAKEAWAYS

Simple sentence-format (subject/verb/object)

Eg. The cat/is sitting/on the wall.
Subject/verb/adverb
E.g. Raghu /is absent/today.
Subject/verb/infinity
Eg. She /is going/to play.
Compound Sentence-Combine two simple sentences with a conjunction (and, or, but) in
between.
Simple sentence+ conjunction+simple sentence.

29
Eg. I ran fast/but/I missed the train.
Noun clause - Subject/+ verb/+ that/+ simple sentence.
Example: I /believe/that /the climate is getting colder.
Adverb Clause - Simple sentence + Conjunction +simple sentence.
Example: He cleared the exam/although/the exam was very tough.
Adjective clause - Describes the noun of a sentence using two words (which, who).
Education which is very important/should be given to all

30
 6. Building confidence and avoiding stammering.
Speaking is something that has to do with the mind. In terms of getting
comfortable and becoming perfect with the language. It also requires confidence.
The art of speaking is a matter of practice.

Identify where you are lacking, and how to improve. It requires a lot of
practice and assessment, where you need to identify areas that you need to
improve and work on.

Every person might lack in some thing or the other. When it comes to speaking,
self-assessment is needed to identify where you need to work on and improve
with practice.

Once you identify where you are lacking, like grammar, pronunciation, fluency, accent, mother
tongue influence, sentence formation, pauses, coherency, vocabulary, clarity of content, or anything
as such.

Once you identify your challenge, focus on it. You can start focusing on improving one thing at a time.

It is not possible to work-on and improve everything at the same time.

You can make a checklist of the areas where you need to improve and you
can start practicing one thing at a time

Say, for example, first you can start focusing on grammar alone. You can record play and listen. Make a
list of all of the grammatical errors that you are committing, and make a note of it.

Practice how to improve and rectify those mistakes. Then again the next time
when you practice you can check if you're committing the same mistake and see if
your mistakes have reduced or have only increased.

Once you do this with time, definitely your grammatical mistakes will come
down and eventually become zero. Once you focus on improving your grammar
and feel you have improved in that, then go to the next thing on the checklist which
can be your sentence formation or anything else which you feel you are lacking.

Then focus on framing your sentences. See, how you can use simple sentences,
complex sentences, and how to frame sentences so that you can get perfect with
framing sentences.

Consistency is the key to practice, say you start practicing grammar, you get perfect, and almost all
your mistakes reduce to zero or one. But once you stop the practice and you don't practice for a week or

31
two, whatever mistakes you committed on the first day are prone to happen again just because your
consistency is lacking. Perfection is a matter of consistency.

You can also identify the psychological challenges that you have and think
of how to tackle them.

Eg:
Pauses,
Taking long pauses in between
Stammering,
Fear,
Repeating the same words many times in a sentence, reframing the sentence,
Breaking sentences, not completing them, and reframing the same sentence, etc.

You can make a list of things like this which you are lacking.

When you are asked questions, you mustn't leave a break or take time to think
about what you need to answer. When you are asked to address some concerns of
the patient. It is not appropriate to take time to think and pause before you give
your reply.

There can be several reasons which can cause this. Fear, being tense or
panicked, or it can also be a habit too. There are a few ways, which you can use
to avoid these. The easiest one is by using fillers.

When you need time to think. You can say, could you please give me a moment or something like
that. You can give a filler like that and then you can use that time to think, what you are going to convey next.

You can also get used to adding idioms and phrases at instances like that. Once
you get comfortable with using them in practice.

They will also become habitual and get corrected with practice. You should
also ensure that you avoid casual terms. Anything which you use out of habit. Like,
err, hmm, repeating any specific word, etc.

Usage of fillers and the need to use them - fillers are generally helpful when you need time to think.

When you are stressed about handling the situation.

When the patient is not very cooperative to handle or is very rude to handle.

At these times, it will be useful.

Maintain a medical vocabulary, where you can list some of the common

32
medical terms that you use, and this will be easy to use if needed.

Once you start practicing and using it. You can keep a few standard ones to use
during practice. This can also be used to see before the exam.

When you are not very comfortable addressing the examiner or the situation of the exam, or when you
are stressed about the outcome of the exam. This can cause nervousness affecting the way you respond
and face the examiner.

However, all this is just a matter of the mind. So, you mustn't let your
psychological stress affect your performance in any way.

You must be bold and confident in the content because you need to have in mind that you are not
judged by content. You will be judged for your language and the way you handle the situation.
Whether you prove that you are efficient at handling it or not matters.

Stammering is another thing to be avoided. It is also a common aspect of the

same scenario. Stammering can be avoided with a conscious choice. When you
practice, start from the first if you stammer. Instead of continuing, if you pause
again, once again start right from the beginning. Do this continuously.

With practice, repetition helps in avoiding stammering and pauses.

Register in your mind that you have committed a mistake and you need to
change the way of how you tackle it.

Such that, every time you commit a mistake starting the same sentence again trying to give the
same response by reframing the sentence will help you register and identify what mistakes you are
doing, consciously.

In addition, this also plays a major role in reducing stammering and getting
comfortable with speaking continuously without pauses.

KEY TAKEAWAYS

Identify where you are lacking, like grammar, pronunciation, fluency, accent, mother tongue

33
influence, sentence formation, pauses, coherency, vocabulary, clarity of content, or anything as
such.

After identifying focus on those areas.

It is not possible to work-on and improve everything at the same time therefore make
improvements one by one.
You can make a checklist of the areas where you need to improve and start practicing one
thing at a time.
Make a list of all of the grammatical errors that you are committing, and make a note of it.
Identify the psychological challenges that you have (if any, from the list) and think of how to
tackle them.
Maintain a medical vocabulary, where you can list some of the common medical terms that
you use, this will be easy and quick to use if needed.
You are not judged by content. You will be judged for your language and the way you
handle the situation. Whether you prove that you are efficient at handling it or not matters.
Register in your mind that you have committed a mistake and you need to change. Such that,
every time you commit a mistake, starting the same sentence again trying to give the same
response by reframing the sentence will help you register, what mistakes you are doing,
consciously.

34
 7 TECHNICAL KNOWLEDGE AND LACK OF
HANDLING IT.
All the role play questions in this exam are based on different departments or hospital setups.

Lack of working experience in the departments mentioned in the scenario might create less confidence
or instability during the role play.

Regarding technical knowledge. An important fact to be remembered is that this exam is a language
competitive exam where you are not judged for the technical knowledge involved in the roleplay.

If there are questions asked by the patient in terms of technical knowledge or details, You can
always give responses without mentioning the technical details involved in the answer.

Say, for example, you can state that you are not authorized to do so. You can frame it more
professionally.

Example:

I am so sorry that I am not the right person to address this concern of yours.
However, the doctor will be here in a moment to address your concern and provide you
with the necessary details.

Could you please give me a moment? I will check regarding this with the
doctor/concerned person and get back to you.

The doctor is on rounds. Once he's back, he will address this query of yours. I hope
this helps.

These are a few responses that you can give in a conversation, where you need to continue the
conversation without ending it.

However, when you want to end the conversation without answering a few questions. You can redirect
the query to the concerned person who is in the same hospital.

Say for example,

It is a case regarding the ortho department. You can direct them to the physiotherapist in the hospital. If
they have any concerns or doubts regarding the same.

If it is something related to nutrition, and they ask something about diet, you can always say that you will
direct them to the nutritionist of the hospital who will guide them and provide them with the necessary
information.

35
 The same thing can be applied mostly for all major departments where you can direct them to the
concerned person. If the scenario, allows you to do it.
When you ask a patient to wait if they are not patient enough to wait till the doctor arrives or
they ask you that they need to be addressed immediately.

In that case, you can ask them time. Up to a minute, stating that you will check and get back to them at
the earliest.

You can also ask these questions:

If something is troubling them at the moment?

If they are having any difficulty?
What is disturbing them at the moment because of which they want to meet the
doctor?
Do they have any needs to be addressed immediately?
if there is something which they are uncomfortable about?
You can assure them that you will provide temporary relief so that they feel better.

Asking questions in instances like these helps in prolonging the conversation. In times
when the conversation seems to be on a halt and the patient says, I'm sorry, I need to see the doctor.
I cannot wait, etc.

In worst-case scenarios where you need to prolong and keep the conversation going. You can
give information which you are pretty sure of, which you are authorized to convey.

However, the accuracy of it doesn't matter. Because it is not involved in how your score will be
accessed.

Hence, no matter which setting or department it comes from. May it be Accident and Emergency
setting ward or psychiatry, gastroenterology clinic, suburban clinic, etc., or any other department.
Even if you are not sure of the details involved technically. Do not hesitate, be confident to answer
and take the situation forward. Be confident to ensure that you are capable of handling the situation,
professionally.

KEY TAKEAWAYS

If there are questions that are asked by the patient in terms of technical knowledge or
details, you can always give responses without mentioning the technical details involved in the
answer.
In worst-case scenarios, where you need to prolong and keep the conversation going, by giving
information. You can give information which you are pretty sure of, which you are authorized to
convey.
When you ask a patient to wait if they are not patient enough to wait till the doctor arrives or
they ask you that they need to be addressed immediately. In that case, ask them time. Up to a
minute, stating that you will check and get back to them at the earliest.

36
37
 8. making situations diplomatic
There are different ways to make a situation diplomatic. Depending on the
way you handle it.

The first one is repeating. Repeating - I do not necessarily mean by telling the same thing of what you
have already said again and again.

However, repeating the same content that you have mentioned has its benefits.
Repeating helps to prolong the conversation, to keep the conversation going.
Sometimes, repeating the same thing over and over again can also help in convincing the
patient with time.
There is no need to think about what is the next thing that you are going to convey when you
are already conveying the same thing.
It helps to have all your focus on the sentences.
Make sure you do not repeat the same thing again and again. Instead, what you can do is,
you can change the way of how you frame a sentence and convey the same thing.
You can convey the same thing in many other different ways.

For example,

I'm so sorry that I am not able to help you with this.

I'm afraid if this wouldn't be a better option for you.
I suppose this is the best option available at the moment that is good for you.

These are the pros and cons of repeating and the ways of how you can do it.

The second way is by giving alternatives.

For almost any crisis, no matter whether it is in personal life, or concerning

medical scenarios. All scenarios have alternatives. However, some might be
helpful. Some might not be helpful.

So, depending upon what is your roleplay scenario. During your preparation time itself. Be prepared
to give alternative options for the crisis of the patient. When you are preparing for your scenario itself,
think of at least one or two alternatives, which you can give for the patient's crisis.

These alternatives can help in convincing the patient in a crisis. Do not tell it once and then stop.
When you are giving an alternative. After you say if the patient has some other thoughts about it.
You can repeat it in different ways by modifying the options.

To get comfortable with thinking of different alternatives. See different case scenarios and think
what are the possible alternative options that you can give based on the patient's discomfort or
the problem.

38
 When you prepare for each scenario, write at least a few alternative options
that you can give the patient.

During your roleplay conversation, depending upon the patient's thoughts and
crisis. One more factor that you need to work on is the convincing factor. (i.e)
How you will convince a patient. For this, it is necessary to take control over the
conversation and scenario.

It is important to convince a patient to gain control over the scenario. To do

this, in the right way. You need to understand what the situation is and how the
patient feels about it.

You can view the situation from the shoes of the patient. After understanding
how the patient feels and what they think about the situation.
You can see what are the best choices, solutions, and help you can offer in this
scenario.
You can also explain any medical terms or procedures if needed, to make them
understand and feel comfortable.
Provide comforting words to make them feel emotionally comfortable.

There are two ways to convince the needs of a patient.

One, by providing comforting words and by comforting with what a patient

needs by reducing the level of their pain, or discomfort they are going through, by
providing any medical assistance.

The second way is by giving reasons. There might be many scenarios

where the patient hasn't understood something or has a different view about
the treatment or procedure they are going to undergo.

Plan ahead, if you need to explain any medical procedures or terminologies if

needed.

You should be able to plan this during your preparation time itself because you
have the case scenario of roleplay.

Based on the roleplay, two things that you need to prepare for:-

See if you need to provide them with any explanation of medical scenarios,
procedures, or terms.

Secondly, try to understand how their mindset will be and how they will be feeling

39
 emotionally about the situation, to prepare for giving reasons elaborately and
professionally.

So, practice these for different roleplay scenarios. Besides, every question write down

Medical terms.
The mindset of patient.
Alternatives to be given.
Anything that needs to be explained.

This you can do for different departments, where the roleplay scenarios and
sample conversations are mentioned in chapter nine.

Handling heated arguments.

There are different scenarios in role-plays involving heated arguments too.

Involving how you handle the different crises, which arise at workplace. Most
of the scenarios have situations where the patient is rude or aggressive where you
need to handle, even if they are not cooperative behaving impolitely.

The basic thing that you need to follow is to be polite with the patient.
Irrespective of how heated the argument gets or how the patient behaves.

Secondly, when the patient's response is very rude. Not everyone will feel
comfortable to respond.

Sometimes, the way a patient reacts can increase your stress which in
turn influences the way you respond.

Due to this, you mustn't let the bad behavior of the patient make you feel
less confident or give up.

Get used to handling scenarios like this comfortably by practicing such

roleplay scenarios. Repeatedly practice scenarios that you don't feel comfortable
with framing responses.

Highlight, and practice those roleplay scenarios, multiple times. Till you
feel comfortable with responding and handling different roleplays.

What are the different answers that you can give, and different ways to convey
them?

Logical Reasoning is needed and is a must in many instances. To convince a patient, you need to
understand different ways of reasoning.

40
 To handle a situation practically. There are several ways to handle each situation and several ways
to respond to each situation too. Irrespective of the scenario, give assurance in every conversation to your
patient.

As patients generally have fear of certain procedures or health issues.

They have stress due to pain or discomfort, etc.

Due to this, assure them that everything is okay, and the situation is under
control. So that they will eventually feel better.

This is an assurance which you need to give in almost every roleplay

scenario because every patient has either fear of some procedure or health or
discomfort due to their disease or pain or stress.

The examiner might want to check your ability to handle the situation through
this.

KEY TAKEAWAYS

Try repeating the same content by rephrasing.

Giving alternatives. Depending upon your roleplay scenario. During your preparation time
itself. Be prepared to give alternatives for the crisis of the patient.
See different case scenarios and think what are the possible alternatives you can give based
on the patient's discomfort and the scenario.
Explain any medical terms or procedures if needed, to make them comfortable.
Provide comforting words to make them feel emotionally stable.

write down

1. Medical terms.
2. The mindset of patient.
3. Alternatives to be given.
4. Anything that needs to be explained.

During the preparation time.

Be polite with the patient. Irrespective of how heated the argument gets or how the patient
behaves.
The way a patient reacts can increase the stress of how you feel, which in turn influences the
way you respond.
Logical Reasoning is needed and is a must in many instances because to convince a patient,

41
you need to handle a situation more practically.
Provide assurance in almost every roleplay scenario because every patient has either fear of
some procedure or their health or discomfort due to their disease or pain or stress and the
examiner might tend to check your efficiency through this.

42
 9 ROLEPLAY SCENARIOS AND SAMPLE
CONVERSATIONS
1. Setting - General medicine ward

Nurse - 28-year-old male admitted with complaint of fever of unknown origin for the past three days.
Investigations were done and the origin was unknown, a culture test was taken and the patient had to wait
for the report. Empirical treatment (treatment given before diagnosis) was started. The patient is highly
stressed and irritated due to an unknown diagnosis and wants to get discharged as symptoms exist. The
patient is annoyed as he didn't get his culture report yet. Explain the procedure of culture test and tell it
usually takes around 2-3 days for the report to come. Assure him that there's nothing to worry about as all
his other basic parameters are normal and the necessary treatment is given.

Task - Explain why the blood culture report hasn't come yet and the normal routine of
blood culture test that takes time.
Convince the patient they cannot get discharged without the doctor’s approval.
Explain to the patient about their condition.

Patient – You are a 28-year-old male admitted with a complaint of fever of unknown origin for the
past three days. Investigations were done and the origin was unknown, a culture test was taken and you had
to wait for the report. Treatment was started. You are highly stressed and irritated due to an unknown
diagnosis and want to get discharged as symptoms exist. Be anxious that they haven’t given you a proper
diagnosis and reason for your fever. State that you are unhappy with their service and want to get
discharged. Ask questions to understand about your condition and finally agree on waiting for the report.

Task - Ask why the blood culture report hasn't come yet and express your

frustration for the delay.

With an irritated tone tell the nurse that you want to get discharged.

immediately and you don’t care about any procedure

Initially show some hesitation to listen but gradually pay attention to the

explanation that is given by the nurse.

Nurse- Hi, good morning. I am Divya.

I'm the nurse in charge of duty today.

Patient – Hi good morning.

43
 Nurse- How are you feeling now?

Patient- I am not feeling great. I am so frustrated with your hospital procedures.

Nurse- I am really sorry you feel that way. May I know what is bothering you?

Patient-It's been 24 hours since I have been admitted and I haven't got my reports yet, nor a proper
diagnosis has been made.

I would like to get discharged.

Nurse- I understand your concern. You had been admitted with fever.

Since the origin of it was unknown. We have taken a culture test.

As of now, you are on anti-fever medication.

Patient- I do understand that. But I want to get discharged. I am completely frustrated staying here
without knowing anything.

Nurse- What you are going through is completely normal. I request you to be patient for a few more
hours. Once we get the results of your tests we will be able to treat you accordingly.

Patient – At least tell me if my temperature has dropped?

Nurse – Yes your temperature is normal.

Patient- Okay, but why hasn't my report come yet?

44
 Nurse- Well, I can sense your frustration. However, all tests take standard time frames.

Patient- May I know why it is taking so long. Is it the same everywhere?

Nurse- Normally, a Culture test report takes three days to come.

This is the standard protocol that is followed everywhere.

So, I hope you understand that there is no delay from our end.

Patient- I am feeling better now. My fever has come under control.

I would like to get discharged as a proper diagnosis hasn't been made too.

Nurse- I am following you, still, I’m afraid that your health might deteriorate without proper observation
as the origin of your fever is still not confirmed.

Patient- Let the report come slowly. I don’t care about the procedures anymore. Till the report comes I
will go home and take good rest. I am not comfortable being here for so long. Please make arrangements for
my discharge immediately.

Nurse- I am extremely sorry to tell you this. I don’t think it is possible for you to get discharged without
a diagnosis. Since diagnosis hasn't been made yet, I think it is not a good option to ignore and take a
chance. Though you are feeling better you need to be observed.

Patient- I don’t understand what needs to be observed. I am totally fine.

Nurse- It is imperative to observe your condition if you might have any other symptoms which might
progress. Also to understand the reason for your fever.

45
 Patient- I understand. But I have my family at home and they need me. My wife works, and has some
official work, because of which, I need to be available at home.

Nurse- I can see that you have responsibilities that you need to address.

However, I kindly request you to cooperate with our procedures and wait overnight. Tomorrow as soon
as the doctor arrives, you can consult the doctor and follow his instructions for the discharge.

Patient- Isn’t it possible to see a doctor and speak now?

Nurse- The doctor has recommended observation for 24 hours, only post-observation he could give
any comments about your condition.

Patient – Fine, I understand that it is essential. I will try to speak to my family to make alternative
arrangements.

Nurse – Thank you so much for your cooperation. That will be great, you can call me if you need
anything else.

Patient – Sure, thank you.

2. Setting- Hospital ward

Nurse- A 45-year-old female is admitted with a case of anemia. She undergoes blood transfusion
and has mild chills during the procedure. The attender calls the nurse and informs. The attender
wants to know the reason for chills and asks what went wrong. Her BP and all other
parameters are normal. Assure them by explaining that this is a common side-effect, and we
can carry on with the transfusion. Explain the condition of the patient that she is stable and
there’s nothing to panic about.

Task –

• Explain the mother’s condition to the attender and comfort the attender that

46
there are no harmful side effects and provide her confidence that it is perfectly
safe to undergo transfusion.

• Explain a doctor is not available for consultation but still transfusion can be
carried out.

• Calm down the attender and persuade her that it is a common side effect and
it is completely safe to continue with the transfusion.

Patient- Your mother is a 45-year-old female admitted with a case of anemia. She undergoes a
blood transfusion. She has mild chills during the procedure. You ask the nurse the reason
for chills, and you would like to know what went wrong. Your mother’s BP and all other
parameters are normal. You are worried this could be a major issue. Enquire about your
mother’s condition. Be anxious and say that you want to see the doctor and clarify. Be
hesitant to carry on with the transfusion. Understand the reason for chills by questioning
and then agree on continuing once convinced with the explanation.

Task –

• Tell the nurse that your mother is old and has other ailments and you are not
ready to carry on with transfusion.

• Ask if a duty doctor is available to check and consult.

• Question how irresponsibly we can say it can be continued without looking

into the issue as she hasn’t experienced this before.

Nurse: Hi, my name is Preethi. I am one of the registered nurses on ward duty today. How may I
help you?

Patient: Hello, I am Nancy. My mother underwent a transfusion this morning. I have a few concerns
regarding her condition right now.

Nurse: Sure Ms. Nancy. I get that. I am here to clarify your concerns.

Patient: Thank you. My major concern is that my mother is old and has other ailments. I am worried
that she might have some side effects during or post-transfusion.

Nurse: I understand your frustration, Ms.Nancy. I can assure you that your mother is in safe hands.
Let me explain what your mother is going through and that could give you more clarity.

Patient: Okay, please go ahead.

47
 Nurse: Thank you for your patience. Red Blood Cell (RBC) transfusions are a mainstay in the
treatment of anemic patients. Since your mother is having low levels of hemoglobin, we are giving her
transfusions. This is a common method used to increase the level of hemoglobin. So, there is nothing to
worry about. She will be alright.

Patient: Alright, but she is getting mild chills during this procedure. What if it affects her health in any
way?

Nurse: I understand your concern although, I reassure you that this is a common side-effect
experienced by most of the patients undergoing transfusion. Also, we are constantly monitoring your
mother's condition and she is doing well. BP and all the parameters are also normal.

Patient: I cannot take this risk. I would like to see a doctor and consult about this.

Nurse: Your demand is completely reasonable. Right now, the doctor is not available however as I
mentioned earlier there is no harmful effect in this procedure.

Patient: You don't understand my fears. I can only let you proceed after seeing the doctor.

Nurse: Please be calm Miss Nancy. I understand your concern. I request you to be Patient and let us
continue with transfusion. Once your mother’s hemoglobin level rises, we can finish the procedure. Until
then, it is imperative for her condition, to continue the procedure as she is anemic.

Patient: You are trying to calm me down. It is not going to happen. I don't want to see my mother
uncomfortable.

Nurse: Yes, that's true, she is uncomfortable But she will be fine after the procedure, as the oxygen
supply will be leveled up through the transfusion.

Patient: Yes, I do agree with you. However, you are not letting me see the doctor. What if something
goes wrong? As there is no doctor’s assistance too, I’m a little bit scared.

Nurse: I see what you are going through. The doctor will arrive in a few minutes. Then you can consult
with the doctor. Yet this is a simple procedure, so I reassure you that we can carefully monitor and take care
of your mother.

Patient: Don't you think it is irresponsible to do this?

Nurse: Kindly try to understand. If there were serious issues, we would not have started the
transfusion. Since the hemoglobin level is very low, we have started with this.

Patient: I'm not convinced completely.

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 Nurse: Yes, I can sense your frustration. It is good you care about your mother so much. Therefore, I
can guarantee this is going to help your mother's anemic condition.

Patient: Alright. But still…

Nurse: Well, don't you want to see your mother recovering soon?

Patient: Of course, yes.

Nurse: Fine, then you will have to be prepared for such treatments, in the long run. This is the first step
to cure anemia for your mother.

Patient: I agree. I want to see her cured.

Nurse: Yes. Then if you want to avoid these life-threatening circumstances, you should comply with
our treatments. I promise your mother will feel better very soon.

Patient: Okay. I understand thank you. You can proceed with the transfusion.

3. Setting – Suburban clinic.

Nurse – A 26-year-old mother who is anxious about her baby's hand-elbow which happens to be
having swelling and pain post-fall walks in. The mother wants to know about treatment and is worried if
there is a fracture as the baby is cranky and crying. The baby seems to be cranky and disturbed.

Task –

• Find out if the baby’s elbow is broken with basic examination and tests
required.

• Find out what treatment is necessary with the concerned doctor.

• Examine if the baby is crying due to pain or discomfort.

• Find out advice for temporary pain relief and comfort.

Patient – You are a 26-year-old mother who is anxious about your baby's hand elbow which happens
to be having swelling and pain post-fall. You want to know about treatment and are worried if there is a
fracture as the baby is cranky and crying. Enquire if it is a fracture and why the baby is crying. Ask for

49
temporary relief medications to calm the crying baby with anxiousness.

Task –

• Show your anxiety and concern for your child’s condition.

• Ask the nurse about the required treatment.

• Express your worry that your child is hurt and ask whether there is a fracture.

• Listen carefully to the advice given by the nurse for pain relief and comfort.
Ask all your queries to clarify.

Nurse: Hello good morning. I am Joan. I am the nurse in charge of your child's condition.

Patient: Good morning.

Nurse: I can sense that something is bothering you. Kindly tell me how I can help you?

Patient: Yes, I am worried about my baby. I am afraid her elbow might be broken.

Nurse: Oh, that is terrible. Let me quickly examine your child. We are here to help you don't worry.

Patient: Kindly make it fast.

Nurse: Sure, I have examined your baby’s arm. It is not broken but there is a minor fracture.

Patient: Oh my God. Will she be alright? Can you do something quickly?

Nurse: Don't be alarmed. This fracture can be cured easily. This is a nondisplaced fracture called
‘Hairline Fracture’.

Patient: Okay, what treatment is required for her?

Nurse: We can treat her with casting or splinting. If the broken bone is not lined up, the bone may
need to be set by our doctor.

Patient: It sounds easy. My baby is small and how will she tolerate the pain? I guess already she is
experiencing a lot of pain. She does not stop crying.

Nurse: I understand that you are worried but usually children get healed quickly. When it is fractured,

50
they have tender bones which heal faster so there is nothing to worry about.

Patient: Alright, how can I stop her from crying for the time being?

Nurse: Let me see if she is crying due to pain or discomfort first. Yes, she is crying because of pain.
Until we align the bone, she might experience pain. Kindly elevate the limb and do not move her elbow. I will
apply an ice pack before the physician arrives

Patient: Yes, that would be better. Could you also provide any painkillers?

Nurse: I am sorry. I am not authorized to give a painkiller. A physician will provide painkillers under
necessary circumstances.

Patient: Well, I can understand.

Nurse: The ice pack will reduce her pain so there is nothing to panic about. We will be here taking care
of your baby.

Patient: Fine, will this affect her elbow position in the future?

Nurse: No, definitely not. As I told you earlier in this hairline fracture bones are not broken into two
pieces, only a minor crack has happened. She will recover very soon.

Patient: That's fine. Could you suggest some advice for temporary pain relief and comfort?

Nurse: Yes of course. Kindly make sure the child doesn't move in any way that involves the injured
area. She can use crutches or a cane if it helps.

Patient: Okay that's helpful.

Nurse: In addition to this, you can sit or recline with her hand elevated. This could reduce the pain.

Patient: Sure, I can do this.

Nurse: Do you have any other concerns?

Patient: No, thank you.

Nurse: Sure, we are here to assist you in any way if needed. The doctor will be here soon.

Patient: Thank you.

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 4. Setting – Operation theatre-recovery room

Nurse – You are a nurse in the operation theatre recovery room. A 75-year-old male Mr.John is
recovering from knee replacement surgery. The patient has trouble getting thoughts of where he is and keeps
asking for his son and says he's feeling cold. He fails to remember and get thoughts on where he is.

Task –

• Explain where he is.

• Help him gather his thoughts by providing comforting words.

• Check for understanding, re-explain if necessary.

• Explain he can see his son once he is shifted to the room in some time.

Patient – You are John a 75-year-old male who is recovering from knee replacement surgery. You
have trouble getting thoughts of where you are. You keep asking questions about your son and you feel
cold. You don’t remember or recollect where you are and why you are here.

Task –

• Ask questions to know where you are.

• Tell the nurse you are finding it difficult to get your thoughts back.

• While speaking, tell the nurse you need more explanation.

• Ask questions about your son and seek assistance as you feel cold.

Nurse: Hello, good morning, I am Scarlett. I am the nurse in charge to take care of you. How are you
feeling, Mr. John?

Patient: Hi, I am sorry; could you tell me where I am? Why do you have to take care of me?

Nurse: Mr. John, please calm down. I'll explain everything in detail.

Patient: Yes, please.

Nurse: Firstly, take a deep breath and relax, there's nothing to fear. You underwent knee replacement

52
surgery. You are recovering from the surgery. The surgery went well. You are perfectly fine now.

Patient: Is it so? But I do not even remember coming here.

Nurse: You were given strong medications which have resulted in drowsiness and tiredness. If you take
a rest, you will be able to remember everything again.

Patient: I am finding it difficult to get my thoughts. What shall I do now? Will this be permanent?

Nurse: Don't worry Mr. John. This is just an aftermath effect of the drugs that were given to you during
the surgery. This will not even last for a day. After proper food and rest, you will be alright. I am here to help
you get through this; I can help you get back your thoughts.

Patient: Yes, please tell me more details about me and my condition.

Nurse: You are 75 years old. Your name is John. You were brought here by your son as there was a
severe rupture in your knee. You had to undergo surgery for replacement. You are now back from the
surgery. You will be here for a few days to receive postoperative care. We will be here to help you with
everything you need.

Patient: I see. When will I get back to my normal state of thoughts?

Nurse: I can follow what you are worried about. I assure you will be normal once you eat your meal, take
medications, and get a good amount of sleep. Would you like to have anything now? I can arrange it for you.

Patient: I don't feel like eating or sleeping. Thinking about everything and recollecting memories are
frustrating.

Nurse: It is understandable Mr. John. If you prefer, I can provide more explanation to help you.

Patient: That would be helpful.

Nurse: Your son took care of you till surgery. He will visit you during the visiting hours. Due to aging,
your knee ruptured and you come for a regular check-up to this hospital. You were thoroughly checked
after the surgery. Your BP and all Parameters are normal. You will feel normal in a few hours.

Patient: Thank you for explaining. I remember my son a little.

Nurse: That's nice to hear.

Patient: At what time will my son come?

53
 Nurse: He will be visiting you during the visiting hours, that is 4 PM to 6 PM in the evenings.

Patient: Will he bring my family also?

Nurse: I'm extremely sorry, as per the hospital guidelines only one person can visit during post-
operative care. But in a few days when you are shifted to a normal ward, your family will also be visiting.

Patient: Okay.

Nurse: Do you need anything else right now, Mr. John?

Patient: Yes, I feel very cold. Could you do something about it?

Nurse: Sure, you can have some hot water then I can provide you a thick blanket. I also would
recommend you to eat your meal to feel healthy.

Patient: Alright, thank you.

5. Setting - Hospital

Nurse – A 40-year-old female with a complaint of shaft of humerus fracture had a cast before two
weeks has walked in for review. She wants the cast to be removed as she finds it uncomfortable and feels
better. She hasn't taken the x-ray which she was advised to take and bring on her follow-up visit. She
refuses to take the x-ray as she feels better and has no time. She says she wants to leave after removing the
cast to work immediately.

Task –

Advise her that she needs to go for an x-ray and bring it as advised.
Explain how only the x-ray report and her healing progress will only decide when her cast
will be removed.
Ask questions to understand the progress of healing and how she feels.
Explain though she might feel better, only an x-ray will decide how the progress of her
healing is internally.

Patient- You are a 40-year-old female with a complaint of shaft of humerus fracture and had a cast
before two weeks, you have walked in for review. You want the cast to be removed as you find it
uncomfortable and feel better without it. You haven’t taken the x-ray which you were advised to take and
bring on your follow-up visit. You feel that you have completely healed as you do all your daily chores
without discomfort. Tell that you want the cast removed and you don’t have time for an x-ray because you

54
have a meeting at work.

Task –

• Try to tell the nurse that you feel better, and you don’t think it is really
necessary to take an x-ray.

• Ask the nurse if the cast can be removed and you can take the x-ray later.

Tell the nurse you understand the importance of x-ray and healing progress
Answer the questions of the nurse about the progress of healing.
Tell her that you are running late to work so that you want to remove the cast and leave.
Later after understanding the importance of x-ray agree to come back and take it.

Nurse: Hi my name is Varsha. I am one of the registered nurses working in this hospital. How may I
help you?

Patient: I came here with the complaint of a shaft of humerus fracture. I had a cast for 2 weeks. I want
to have a review.

Nurse: Alright let me check your details. I have some questions regarding your condition. May I
proceed with it?

Patient: Yes, please.

Nurse: Thank you for the confirmation. I could see that you were advised to take an X-ray and bring it
on your visit today. Could I see your x-ray report, please?

Patient: Actually, I felt good and that's why I didn't think it was necessary to take an x-ray. So, I did
not bring it.

Nurse: I understand, but the doctor would like to see your x-ray. Would you mind taking one now and
bringing it back?

Patient: But why do I have to take an x-ray? I feel alright now. You can take the cast now. I don't
think the x-ray is necessary.

Nurse: Kindly understand that only your x-ray report will provide enough details about your bone's
healing. We cannot take the cast until we see the x-ray report. Also, your healing progress will only decide
when the cast can be removed.

Patient: Ok, could you remove the cast now? Can I bring the X-ray report later?

55
 Nurse: I am sorry to say this. That might not be possible as I mentioned earlier, only your x-ray report
and healing progress can decide when the cast should be removed.

Patient: Ok, I'll take the X-ray.

Nurse: Thank you for understanding. Your X-ray report will help us understand how your bones are
getting better.

Patient: I am sorry that I didn't bring the X-ray report. I will take one now.

Nurse: Thank you. Would you mind me asking some questions about your healing progress to see
when we can remove the cast?

Patient: Yes, please go ahead.

Nurse: Could you tell me on a scale of 0 to 10, how you would rate your pain?

Patient: Currently, I can say it has come down to 4, 5

Nurse: That is a good improvement. Could you tell me how you feel when you do your routine work?

Patient: It is still difficult for me, but I am trying to manage.

Nurse: Could you tell me, if you are following the instructions given by the physician properly?

Patient: Yes, I have followed them.

Nurse: Could you tell me how you feel while giving minute movements to that part?

Patient: I feel minor pain, but it is manageable.

Nurse: Are you taking medications regularly?

Patient: Yes, I am.

Nurse: I can sense that the progress of your healing is very good. Yet, I would suggest you to wear the
cast for a few more days. I will confirm this after getting the x-ray report.

Patient: Sure, I understand the importance of healing progress.

Nurse: That is good to hear. May I know how you feel right now?

56
 Patient: I am clear. When do you think this can be recovered completely?

Nurse: Please do not worry much about it. You will be alright soon. I am sure if you follow the
instructions regularly you will recover soon.

Patient: Thank you.

Nurse: Thank you for your patience and understanding.

6. Setting – Post-operation recovery ward.

Nurse – 29-Year-old female patient after C-section delivery under general anesthesia is in the ward for
24 hours under observation. The patient has had a history of polytrauma and is in observation to check if
there are any episodes of seizures or other symptoms. She experiences mild chills and is worried if it is a
seizure. Her basic parameters are normal and stable but she is anxious about her condition on having chills.

Task

• Ask questions to find out about her existing health ailments.

• Convince her that she's okay as her basic parameters are stable

• Keep her warm and provide basic comfort to reduce chills.

Patient – You are a 29-Year-old female patient. You have undergone a C-section delivery under
general anesthesia and are in the ward for 24 hours under observation. You have had a history of polytrauma
and are in observation to check if there are any episodes of seizures or other symptoms. You experience
mild chills and are worried if it is a seizure. Your basic parameters are normal and stable. Be anxious about
your condition. Ask why you are experiencing this and try to understand. Enquire if you can see the doctor.

Task

• Answer questions about your existing health ailments.

• Since you experience mild chills express concern that you might have a
seizure.

• Listen to the explanation given by the nurse and comply with the treatments.

57
 Nurse: Hi, my name is Celine. I am the nurse in charge of ward duty today.

Patient: Hello Nurse.

Nurse: You are under observation. You have a history of polytrauma, and we would like to check if
there are any other symptoms.

Patient: Okay.

Nurse: Would you mind if I ask some questions about your health ailments?

Patient: Please go ahead.

Nurse: Do you have a headache or nausea right now?

Patient: Now I am alright.

Nurse: That's good to hear. Do you experience any other symptoms?

Patient: Yes, I experience mild chills and I have had episodes of seizures. So, I am worried if this is
also a symptom of a seizure.

Nurse: Kindly don't worry about that. I have checked your basic parameters and they are perfectly
alright. So, this could just be a normal side effect of the anesthesia.

Patient: But this is how it always starts for me.

Nurse: I completely understand your fear but as your vital parameters are normal and stable there is
nothing to worry about. You are in safe hands. We will provide you with the necessary assistance.

Patient: Okay.

Nurse: Do you feel tired?

Patient: Yes, I am.

Nurse: Do you have drowsiness?

Patient: No, I am just tired.

Nurse: Alright.

58
 Patient: Is there anything that you can do to stop the chills.

Nurse: I can keep you warm by providing a thick blanket and can give you hot water to drink. I can
switch off the fan too if you need.

Patient: But if that is not working could you prescribe any medications to stop the chills, I am afraid I
might get seizures.

Nurse: I completely get what you are going through but it is not good to take any medications right
now. I am not authorized to give any medication too.

Patient: Alright.

Nurse: Kindly don't worry about anything, this is just for 24 hours, after this observation period you
will be perfectly alright.

Patient: Thank you, that's helpful.

Nurse: Do you need anything else?

Patient: Could I get some hot beverage?

Nurse: I am sorry to tell you this, but we cannot provide you with a beverage while you are under
observation. The anesthesia can cause side effects if you intake beverages.

Patient: Fine I understand.

Nurse: Please be patient. After 24 hours I will provide you with a beverage. Is that fine?

Patient: Yes.

Nurse: You can take rest now. I will see you after 24 hours.

Patient: Thank you.

7. Setting – Hospital ward.

Nurse – A 35-year-old female with complaints of asthmatic attack and lung infection is admitted. She
has a history of chain-smoking. She works in a call center and has stressful work. She is not ready to quit

59
smoking and is highly stressed to be cooperative for treatment when you come to question about her habits
and lifestyle. Calm her by providing empathetic words and make her comfortable enough to talk.

Task –

• Ask questions to understand her lifestyle, eating patterns, and habits.

• Advice her to quit smoking and make lifestyle changes to be healthy.

• Comfort her by talking friendly and by telling her that the treatment and
changes are for her good.

Patient- You are a 35-year-old female admitted with complaints of asthmatic attack and lung infection.
You have a history of chain-smoking. You work in a call center and have stressful work. You are not ready
to quit smoking and are highly stressed to be cooperative for treatment when the nurse comes to ask
questions on your habits and lifestyle.

Task –

• Answer questions about your lifestyle, eating patterns, and habits.

• Hesitate to quit smoking and to listen to advice.

•Justify your stressful situation but eventually assure the nurse to follow
everything that has been suggested.

Nurse: Hi my name is Celine. I am a registered nurse in this hospital and I am here to help you with
your condition. May I know your name, please?

Patient: My name is Divya.

Nurse: Hello Divya, I see that you are admitted with complaints of asthmatic attack and lung infection.
Am I correct?

Patient: Yes.

Nurse: Would you mind if I ask a few questions about your lifestyle and eating habits?

Patient: Sure, go ahead.

Nurse: Thank you for your cooperation. Could you tell me what kind of work you do?

Patient: I work in a call center with extended working hours. It is a stressful job.

60
 Nurse: Oh, I see in terms of diet, could you tell me about your eating habits?

Patient: well, as my job is pretty hectic, I prefer to eat outside food most of the time. I don't usually get
time to cook.

Nurse: That is fine. Could you tell me more about your everyday routine?

Patient: I wake up late in the morning then I would get ready and go to work. After completing work,
I come late at night. I mostly skip my morning breakfast. I also don't get time to spend with my family or
friends anymore.

Nurse: It sounds like a busy job. How many cigarettes do you smoke per day?

Patient: It depends on my work. It is quite stressful sometimes, I even complete a packet that consists
of 15 to 20.

Nurse: Ok. When did you start smoking?

Patient: I started nearly 7 years back.

Nurse: That's a long period, so from whatever you said, I get that because of your stressful job, you
are not able to follow a good diet also. You are not getting time to spend with your family and friends. Have
I covered everything about your lifestyle?

Patient: Yes, you are right.

Nurse: Alright, I follow what you are going through in your life but there can always be a chance to
lead a healthier life, for example, you can quit smoking by trying some alternatives such as yoga, and to ease
the transition you can use a nicotine gum on consulting your doctor.

Patient: To be honest, I actually don't want to quit smoking, and the truth is I cannot do that easily.

Nurse: Sure, that's quite reasonable but have you ever considered going to a rehabilitation center for
new changes in life?

Patient: Sorry, I cannot go to any center as I am already held up with my job and I don’t like to take
up any sessions and advice.

Nurse: Being aware of your health condition, to prevent getting attacks. You need to consider
rehabilitation. Also, I would suggest you to reduce the hours you are working and spend time with family
and friends. This could give you some relaxation and take your mind off smoking.

61
 Patient: Well, I can reduce the hours of work then. If I get time, I can meet my family and spend time
with my friends. I can go out with them. Thank you, that is something I can try. After all, I don’t want
another asthmatic attack.

Nurse: Glad I could help. There are also some treatments we have in our hospital for you to get better.
It will help you to avoid these life-threatening circumstances in hospitals.

Patient: Alright, I can take those treatments and try quitting smoking.

Nurse: Thank you so much for your patience and cooperation. We will provide you with the details
about the treatments and you can proceed.

Patient: Thank you.

8. Setting – Psychiatry ward

Nurse – A 25-year-old female is admitted due to panic attacks and dizziness. She complaints of it
along with chills and palpitations. The patient has a prior diagnosis of clinical depression and has been
on SSRIs supplements and CBT for treatment. The patient is anxious to know and understand what she is
going through. She feels that she wants to sleep and needs a sedative to be prescribed.

Task –

• You are the nurse on duty, enquire if the patient has had any incident or
reason that triggered this and how she has been feeling last two days.

• Ask if she has been following her prescribed medicines.

• Convey you have no authority to give sedative and the details but will check
and tell shortly.

• Assure her that she's okay by providing comforting words, after enquiring
and understanding her concerns.

Patient – You are a 25-year-old female and are admitted due to panic attacks and dizziness. You
complain about chills and palpitations too. You have a prior diagnosis of clinical depression and have been
on SSRIs supplements and CBT for treatment. You are anxious to know and understand what you are going
through. You feel like you want to sleep and need a sedative to be prescribed.

Task-

62
 •Answer in detail to the questions about the cause of your condition and
explain how you have been feeling for the past two days.

• Explain that you couldn’t follow the prescribed medicines due to the fear of
side effects.

• Show the Nurse you are anxious and ask if a sedative could be prescribed
to sleep.

Nurse: Hi my name is Cathrine, one of the registered nurses assigned for you today. How are you
feeling now?

Patient: Hello nurse, I am doing well.

Nurse: Great, would you mind if I ask some questions about your condition?

Patient: Please go ahead.

Nurse: Thank you for the confirmation. You have been admitted with complaints of a panic attack and
dizziness. I see that you also have mild chills and palpitations. There has been a prior diagnosis of clinical
depression also, and you were on selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral
therapy. Am I correct?

Patient: Yes.

Nurse: Alright. Could you tell me if there was any particular incident that caused the depression?

Patient: Yes, I lost a family member recently.

Nurse: I am sorry for your loss. Could you tell me when it happened?

Patient: It happened 9 months ago. After that, I started experiencing depression.

Nurse: I honestly understand your circumstance. Do you think it had something to do with the panic
attacks which you got 2 days ago?

Patient: I don't know it could be a reason. After CBT and SSRIs supplements, I felt good, I was
alright completely but suddenly I got this panic attack and dizziness.

Nurse: That's fine. Did you recollect or think of any memories about that family member recently?

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 Patient: I am not able to forget the loss completely. Although, I do have the memory then and there.

Nurse: Ok, I get it. How do you feel now after being here for 2 days?

Patient: I don't have chills, palpitations, or dizziness but there is a fear that I might get a panic attack
again.

Nurse: Please don't think about the panic attack, now you are perfectly alright. We are here to always
help you. Do not worry. Could you tell me if you have been following the prescribed medications?

Patient: No, I didn't take the medicines properly because I am afraid it might cause some side effects.

Nurse: I sense your anxiety, but you will recover soon only through proper medications. I kindly
request you to follow the medicines regularly.

Patient: But, I am always thinking about the panic attack I got. I am not able to sleep. The fear is
acquiring my mind.

Nurse: What you are feeling is perfectly normal. Anyone in your condition will feel the same but if you
try to take the medicines and rest for a while, you will see some improvements in your condition.

Patient: I am trying but I am not able to sleep.

Nurse: I can follow that you are going through a very difficult time yet your health is very important.
So, try to have your medicines and if you need anything else we will provide you. We are here to help you.

Patient: Could you at least tell me what I am going through? Why did I get this suddenly?

Nurse: Your need to know, is understandable but I am sorry to tell you that I am not authorized to
explain about your condition. The doctor will be here soon, he will explain everything in detail.

Patient: Can you at least provide me with some sedatives so that I can sleep. I am frustrated and I
couldn't sleep yesterday.

Nurse: I will check with the doctor with your demand and get back to you. I have no authority to
prescribe a sedative. Please be patient and don't worry about anything. You will be alright soon.

Patient: Only if I sleep, I will be alright, but you are not providing the sedative also.

Nurse: Kindly cooperate with us and understand I cannot prescribe a sedative for you right now, but

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the doctor will be here any minute. You can explain your condition to him. I am sure you will be fine soon;
you only need rest. Kindly be relaxed and try to sleep.

Patient: Okay. I will try to sleep.

Nurse: Thank you so much for your cooperation.

9. Setting – Gastroenterology clinic.

Nurse – A 50-year-old male was admitted with complaints of nausea and dizziness. He has a history
of high BP, gastric troubles and admits that he is an alcoholic. He enquires about quitting alcohol. Ask
questions to understand the patient’s lifestyle. Advise him on ways to quit drinking.

Task –

•Question him on his drinking, eating, and exercise patterns.

• Suggest ways in which he can modify his lifestyle and health.

• Be friendly for his reasons for not being able to quit and refer him to
join a rehabilitation support group if he is interested.

Patient – You are a 50-year-old male. You were admitted with complaints of nausea and dizziness.
You have a history of high BP, gastric troubles and admit you are an alcoholic. Enquire about quitting
alcohol. Answer questions patiently. Admit you have tried quitting, but you cannot.

Task –

• Answer questions about your drinking, eating, and exercise patterns.

• Explain you have tried hard to quit drinking, but you failed and it feels
impossible.

• List down the reasons why you couldn’t quit drinking and seek advice to stop
it permanently.

Nurse: Hello, good morning my name is Jena. I am the nurse in charge of duty today. May I know
your name, please?

Patient: Hi my name is Sam. I was admitted with complaints of nausea and dizziness.

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 Nurse: Ok Mr. Sam. You have a history of high BP and gastric troubles. Am I correct?

Patient: Yes, you are right.

Nurse: Do you consume alcohol?

Patient: Yes.

Nurse: How often and how much amount of alcohol do you consume?

Patient: I am an alcoholic. I drink a lot every day.

Nurse: Ok, I get that. May I ask some questions about your lifestyle and eating habits?

Patient: Yes, of course, please go ahead.

Nurse: Thank you for the confirmation. Tell me something about your job.

Patient: I work in an IT Company. My job is pretty stressful as I am the manager of a team.

Nurse: Ok, so tell me about your eating habits.

Patient: As my job is stressful, I tend to eat more junk foods. I try to reduce it but I am not able to
do that.

Nurse: How much exercise do you do every day?

Patient: Frankly speaking, I do not exercise at home. I start early to work and sometimes I come
back late. I don't get time to exercise.

Nurse: That's understandable, as you have a busy job. Could you tell me how this alcohol
consumption started?

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 Patient: I started drinking socially to avoid the stress. However, currently, it has reached a stage
where I badly need to drink alcohol before sleep now, it has become almost an addiction.

Nurse: Alright, from what you have said, I understand that, because of the stressful job you have
got into this alcohol consumption. You don't get time to relax and do some exercises. Am I correct?

Patient: Yes

Nurse: Please don't worry this could be changed easily. You can try to find some time to spend
with your family and friends. If you are not able to do exercises you can start with walking regularly
for a few minutes, even on your terrace. If you start relaxing your mind from the stress you have, you
can surely stop the consumption of alcohol.

Patient: I have tried quitting alcohol consumption but I couldn't, it is very difficult to stop.

Nurse: Even if you can't stop immediately, you can reduce your consumption little by little and do more
exercises and things like hobbies to relax yourself every day.

Patient: It is helpful. I'll try my best.

Nurse: Thank you for your cooperation.

Patient: I couldn't quit alcohol consumption as I am 50 years old. I am not getting the motivation to
relax, so the easiest way is to consume alcohol.

Nurse: I am following what you are going through. Don't worry Mr. John this is very common
among so many people. It is curable. If you need a change, you can join a rehabilitation support
group if you are interested. They will help you to come out of alcohol consumption very easily. You
will also get to meet new people and there will be a lot of activities you can carry out for relaxation.

Patient: That sounds great, but will this be helpful to stop alcohol consumption permanently?

Nurse: Yes, it will help you until you feel that you can be strong enough without the consumption of
alcohol. You can seek support from the rehabilitation center. They are very kind and helpful. They will
assist you according to your interests. They will support you in all the stages of your addiction. You

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 will feel better very soon.

Patient: Thank you for the information.

Nurse: Glad, I could help, let me know if you need further details.

Patient: Sure, thank you.

10. Setting – Psychiatry ward.

Nurse – You are the nurse on duty. You are assigned to fill questionnaires on health, habits, and
lifestyle for new patients as a part of their health history. You are enquiring to a person who is chronically
depressed and is undergoing CBT for social behavior and relationship building. She doesn't want to speak.
She feels uncomfortable and believes that there is no need for her to convey personal details.

Task –

• Make the person comfortable to initiate a conversation and answer.

• Ask why she is not ready to speak and if she is undergoing any trouble at
present.

•Review files of previous visits to understand if she has taken medications

and followed the advice.

Patient – You are a patient who is chronically depressed. You are undergoing CBT for
social behavior and relationship building. You don’t want to speak. You feel uncomfortable because you feel
there is no need for you to convey your personal details to the nurse. Act rude and uncooperative to share
details when questioned. Tell her it is your privacy not to share. Ask questions and understand why she asks.

Task –

• Be reluctant to answer questions.

• Explain your discomfort and tell that you don’t want to give details.

• After the review of your files answer questions if asked.

Nurse: Good morning, I am Shantha, the nurse in charge of this ward. How may I address you?

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Patient: Good morning, you may call me Riya.

Nurse: Hello Riya! I notice that you haven’t filled your questionnaire yet and you appear
disinterested. May I know what is bothering you?

Patient: Well why, do I need to answer you? I am here for some other purpose. I feel I am wasting
my time by being here. Can I leave?

Nurse: I can understand your apprehension Riya, but the purpose of this questionnaire is to address
all your concerns and queries by improving the quality of treatment provided to you from
our end. It will be of great help if you can explain why you feel that answering these
questions is a waste of your time. Can you do that for me?

Patient: I do not see a reason why I should explain everything to you. I do not want to talk to
anyone other than my doctor. I really would like to meet him to finish my session for today
and go back home.

Nurse: Well, no problem if you do not want to converse with me or answer these questions. I am
curious about what has been planned for your session today! Can you tell me what time
has the doctor given you an appointment? so that I can find out when your session will
begin, and I can arrange all the necessary things for it?

Patient: Hmm... I am here for the Cognitive Behavioural Therapy session that the doctor has
assigned at 11 am today. I thought if I came in at 10 am I could finish my session early, but
that does not seem to be the case here.

Nurse: Thank you Riya for letting me know that. If you do not mind, can you tell me why you do
not want to talk to me or any of the others who are present here along with you?

Patient: I honestly do not feel comfortable interacting with strangers and people in general.

Nurse: Oh, that is bad! I would like to know you. You seem like an interesting person. Have you
always felt an aversion towards interacting with anyone or is this due to some ailment that
is prevailing presently?

Patient: I seriously do not want to talk about it! I prefer the details to be personal and to remain
between me and my therapist only.

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Nurse: I understand why you are reluctant to interact with me. I will not force you to interact
unnecessarily. You can wait until the doctor arrives. In the meantime, can I have a look at
your file so that I can enter the details into the case file we have for you?

Patient: Here you go!

Nurse: Thank you... After looking at your file I can see that you have been severely depressed over
the past year due to the traumatic experience you faced shortly before. I am so sorry that
you are in this situation. At your comfort, could you please tell me if you have been taking
these medications prescribed by the doctor regularly?

Patient: Since you have gone through my file, I hope you should understand that I am coming here
for behavioral therapy, and I haven’t seen any need to take the medications regularly.

Nurse: Well, that is interesting. When do you feel the need to take medications then?

Patient: Most days I feel down and low, so I refrain from taking the medicines all the time. I reduce
the dose to once a day. When I feel happy, I do not take any medicines at all. Only when I
feel that I cannot function at all, I take medicines as prescribed.

Nurse: As a nurse in this ward, I have seen a lot of such patients who moderate the medications as
per their own will and wish. In my professional view, I would strongly advise against that
because the chances of relapse and your therapy not working are increased with improper
medication.

Patient: Oh! I was not informed of that earlier. I thought these medications were to be taken on an
SOS basis.

Nurse: Well, that is not the case her Ms. Riya. No problem, we will get it corrected from now on. I
also noticed that the doctor has advised you to join yoga and meditation classes. Have
you joined any?

Patient: No. I don’t have time to do all these things. I tried doing it once, but I fell asleep and had
severe nightmares. So, I never attempted it again.

Nurse: Oh, I’m sorry about that, Maybe our in-house yoga trainer might be able to give you a few
tips and tricks to deal with that.

Patient: Hopefully.

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Nurse: I couldn’t help but notice the doctor has asked you to write whatever you do in a day in a
diary. Have you written anything in the diary that you have with you?

Patient: I have made a few entries on the first few days following my meeting with the doctor. Later I
started writing once a week or only when something happens out of the ordinary. Other
than that, I have not written anything.

Nurse: I am glad that you have attempted to write at least a few entries. That is helpful for us in
tracking your progress and for you to reflect on how far you have come from where you
were a few months back.

Patient: Hmm... That is an interesting interpretation. I did not see it that way. Maybe if I wrote more,
I would get better soon.

Nurse: That is what we aim for, here. All we need for you is to get better soon and be cooperative
with us. Give your best so that we can work together and make you live a better life.

Patient: Well, that sounds promising. I really want to work on myself, but I usually get scared of
social interactions. I feel being alone and away from people keeps me inside my safety
bubble.

Nurse: I am sorry that you feel that way. We will work together towards getting rid of the
discomfort you feel around people.

Patient: Thank you. It was a nice opening to someone after a long time.

Nurse: We are always here to help you. If you have anything else to share you can always feel free
to talk to me.

Patient: Well as of now, I am feeling a lot better compared to when I came in. Thank you for that.

Nurse: It was a pleasure interacting with you. I will inform the doctor that you are waiting.

Patient: That will be great. Thanks.

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 11. Setting - Gastroenterology clinic.

Nurse- A 35-year-old male who has had an endoscopy, three days ago, walked in complaining of
heartburn and nausea. He doubts if something went wrong in the procedure. Question him to understand his
symptoms and assure him that it can be a common effect followed post endoscopy. Suggest temporary relief
and direct him to the Doctor.

Task –

• Assure the patient that nothing went wrong in the endoscopy.

• Calm down the patient and apologize for not explaining the side effects.
Reassure it would not happen again.

•Suggest temporary relief and direct him to the doctor.

Patient – You are a 35-year-old male who has had an endoscopy, three days ago, you walk in
complaining of heartburn and nausea. Ask questions to understand your symptoms if it can be a common
effect followed post endoscopy. Find out, temporary relief and ask for a consultation with the doctor.

Task -

• You are highly stressed and anxious if something was wrong with the
procedure.

• You are angry as adverse side effects, and lifestyle wasn't advised properly.

• Ask about temporary relief medication and find out if a doctor is available to
check.

Nurse: Good morning, I am Aziz, the registered nurse in this gastroenterology clinic. How may I
assist you today?

Patient: Hello Aziz, I am Rohit. I underwent an endoscopy procedure here three days ago and I had
a few concerns. Can you help me?

Nurse: Yes Rohit, it will be my pleasure to help and clarify your doubts. At your convenience, please
let me know about your concerns.

Patient: Firstly, I am having severe heartburn and I find it difficult to lie down or relax as the
sensation is too prominent and irritating.

Nurse: Oh! I am so sorry to hear that. So, is this heartburn a recent development post your

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 endoscopy procedure, or have you experienced it before?

Patient: I feel that this is a recent manifestation rather than a pre-existing condition.

Nurse: That is unfortunate. Is that the only complaint you have?

Patient: No. I am also experiencing severe nausea all the time irrespective of whether I eat food or
not I feel very weak and nauseous. So these are the two major complaints that I have.

Nurse: I am glad you shared your concerns and complaints with me. I assure you that we will do our
best to resolve and clarify them in this visit.

Patient: That will be helpful. Now, what do I do? Is this something that one should usually expect
post-procedure or is there something wrong with me? I am really concerned.

Nurse: I can completely understand your apprehension. But I would strongly suggest you relax and
not worry too much as most of the time nausea and heartburn are seen as the common
side effects of endoscopy.

Patient: Why wasn’t I informed of these things before the procedure? Why am I being informed of it
only now? I was worried that something went wrong with the procedure, and I had to rush
here early in the morning. No one bothered to warn me about these things to look out for.
It is making me anxious.

Nurse: I apologize on the hospital’s behalf. It is a standard procedure to inform the patient about the
side effects post-procedure, but it is a high possibility that we might have missed out on
instructing you before discharge as there was a shortage of staff at that time and we could
have missed informing you.

Patient: Hmm... That is understandable. Please bear in mind not to repeat it as it severely traumatizes
the patient.

Nurse: I am so sorry that you had to undergo emotional strain because of our negligence. I assure
you that we will take extra care further and not repeat this mistake.

Patient: Anyway, could you explain in detail once again? It is confusing and I am a little
apprehensive.

Nurse: Sure, I appreciate that you understand our position as well. In short, as a part of endoscopy,
we advise you to fast the previous night and not to consume water as well. Am I right?

Patient: Yes, I was instructed on these by another nurse who was in charge at the time of my
admission.

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Nurse: Well, due to the prolonged fasting your digestive system gets a little upset. Furthermore,
during the procedure, we administer a local anesthetic spray to ease the passage of the
endoscopy tube into the GI tract. Are you able to follow me?

Patient: Yes, I am following you. Please proceed.

Nurse: Thank you. Further, due to this, most patients experience slight discomfort for a week or so
post the procedure as it takes that long for the body to recuperate.

Patient: Yes, that seems to be my case as well. Were there any diet instructions and restrictions that I
was supposed to follow post endoscopy?

Nurse: During this period, we advise our patients to consume light food and drink a lot of water. This
takes care of the discomfort experienced. Am I clear?

Patient: Yes, it is clear. Also, it would have been helpful if I were informed of these things either
before or post my procedure as I could have easily avoided this visit and rested at home.

Nurse: Once again I am sorry for the inconvenience caused due to our mistake. Is there anything else
that I can do for you?

Patient: Yes, I would like to know what can be done to manage this condition now?

Nurse: I am glad you asked this question. As I said earlier, you must consume food with very little oil
and no spices for a few days preferably for one more week. It will be soothing if you drink
at least 4 liters of water every day. You can do some exercise every morning like taking a
small walk around the block for 30 minutes. This will help in easing your discomfort
further. I hope I have made myself clear.

Patient: Great. I will keep a note of these instructions. Can I meet with the doctor? Is the doctor
available for the day? I have a few questions I need to ask.

Nurse: Of course, the doctor just walked in. I will check with the receptionist and get you an
appointment right away. As you are returning for a follow-up consultation, you should be
able to meet the doctor without any delay.

Patient: That will be great. I would like to get back home as soon as possible.

Nurse: Yes, I totally understand your situation. Please wait here while I fix your appointment.

Patient: Well, thank you very much.

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 Nurse: Is there anything else that I can help you with?

Patient: As of now that will be all.

Nurse: Sure. I will be right back with you.

12. Setting - Gastroenterology clinic.

Nurse – A 35-year-old female with a complaint of peptic ulcer, having symptoms of colic pain,
heartburn, and hemorrhoid has come for review due to worsening symptoms. The patient has a bad lifestyle,
due to night shifts at work, and improper eating and sleeping patterns.

Task -

• Ask questions to understand the patient's eating patterns and lifestyle.

• Suggest lifestyle changes and explain why it is essential.

• Explain how her work and eating patterns are affecting her health and
condition.

Patient – You are a 35-year-old female with a complaint of peptic ulcer. You have symptoms of colic
pain, heartburn, and hemorrhoid. You have come for review due to worsening symptoms. You have a bad
lifestyle, due to night shifts at work, and improper eating and sleeping patterns.

Task -

• Answer questions about your eating patterns and lifestyle.

• Explain how hard your work is and seek assistance to make some effective
changes.

• Be open to the suggestions of the nurse about your work and eating patterns
that are affecting your condition.

Nurse: A very good morning. I am Monisha, I am a registered nurse at this gastroenterology clinic, and
I will be attending to you today. How may I help you?

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 Patient: Hi Monisha, I am Angela and I have been consulting with this clinic for some time now. I
wanted to consult with Dr. Mathews.

Nurse: Okay Ms. Angela. If you don't mind me asking, could you please tell me the purpose of this
consultation?

Patient: Well, I have been consulting with the doctor for treating my peptic ulcer for more than a year
now.

Nurse: Okay. So how is your ulcer now? has it become worse?

Patient: That is the reason why I am here today. I have been having an increase in the intensity of pain
in my lower abdomen and near my urinary tract off late.

Nurse: Oh! That is unfortunate. Please tell me more about your complaints.

Patient: Apart from this I am experiencing severe heartburn.

Nurse: Is that all?

Patient: Yes, I feel anxious if there could be something wrong with my stomach.

Nurse: Please do not worry. We will get to the bottom of this and get you better in no time. Before we
move ahead, can I ask you a few questions to understand your condition better?

Patient: Yes.

Nurse: I noticed you mentioned your pain to be very intense recently. Could you please rate your pain
on a scale of 1 to 10, with 1 being the least and 10 being the worst?

Patient: If I had to rate my pain, I would say it is somewhere between 8-10. It has worsened in the
past 3 days.

Nurse: I am sorry that you are in so much pain. I appreciate your opening to me. I should say, you
have walked into the clinic at the right time. Looking at your symptoms, you might have suffered even more
had you not come here today.

Patient: Phew! Glad I made it today. I was planning on postponing this visit till the weekend.

Nurse: Good that you did not postpone your visit. So, moving on, can you describe your regular diet?

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 Patient: I usually do not consume my breakfast. I prefer having a black coffee in the morning and
having my lunch at around 2 pm. After my lunch, I have a cup of cappuccino at 4 pm after which I have my
dinner some days when I feel like eating or if I find time away from work. Most days I skip dinner as well
and have a glass of milk before going to bed.

Nurse: Seems like you are not eating enough. Is there any reason behind such a scanty eating practice
or has it always been like this?

Patient: Unfortunately, this is a recent development as I was recently promoted to a higher position
that offers 10 times more pay compared to what I was drawing earlier. So, most days I spend more than 14
hours at work and probably take breaks to eat and sleep.

Nurse: Phew! That sounds tedious. reflecting on your statement, I guess it is safe to assume that you
do not have any physical activity to keep yourself fit. Am I right?

Patient: Well, you are right there. I find myself crawling into the bed after a long day. I get completely
exhausted most days and that is probably one of the reasons why I have been skipping dinner recently.
Some weeks my work schedule changes to night shifts so that has taken a toll as well.

Nurse: I can understand how exhausting it will be with such a tight schedule and hardly any time to
sleep. We can safely assume that negligence towards personal health is why you have been experiencing all
these symptoms lately.

Patient: Frankly, I just want to stay healthy and have a better lifestyle. Is there anything that we can do
to work towards this?

Nurse: I am glad you want to bring a positive outlook to your life and lifestyle. We will be more than
happy to help you on that front. Before I can move ahead, could you briefly tell me if you will be able to find
some free time from work in the next few weeks?

Patient: Yes, I can do anything to work on my health even if I must take some time off work, I am
ready to do it.

Nurse: Good to hear that. Based on my understanding of your symptoms and pain levels I feel that we
must get a scan done to rule out hemorrhoids since your symptoms are worsening every day.

Patient: Oh, that sounds scary. I hope it is not that bad. I will get it done today. Apart from these, are
there any lifestyle changes which I must incorporate?

Nurse: I am glad that you asked that question. Let’s begin right away. I would like you to know that
incomplete food leads to incomplete nutrition. So, our first point of action should be to get you to eat
healthily.

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 Patient: Regarding Healthy eating, what are the things that I need to incorporate? Could you please
elaborate?

Nurse: To begin, you should incorporate more fruits and vegetables in your diet rather than relying on
fast food and packaged foods. This will help you contain your ulcer and reduce heartburn because
packaged foods contain a lot of artificial flavors that are nothing but strong chemicals that tempt you to eat
more and harm yourself. Fast foods usually contain a compound called Mono Sodium Glutamate, which
gives the consumer a rich taste, is very harmful and there are reports to substantiate this.

Patient: Wow, I was not aware of this. I usually thought fast food was equally healthy if I ate it in
moderation.

Nurse: Unfortunately, that is not the case. Further, most people find drinking tender coconut water
helps soothe heartburn. Of course, there are medications for heartburn, but the less we consume medicines
the better our chances of not relapsing into ulcers again.

Patient: Hmm. Understandable. So, I need to incorporate fruits, vegetables and drink tender coconut
water. Is that all?

Nurse: No, that is not all. You should also reduce the consumption of spicy food and refined oil.
Refined oil has more harm than good. Contradictory to its name, refined oil is another form of poison that
you can feed yourself. We do not want that, do we?

Patient: Absolutely no. I never knew such small components of food can have a huge impact.

Nurse: Good that you agree. Moving further, I would like you to incorporate a few exercises every
day for at least 10 minutes. It can be walking, cycling, or yoga with meditation. Does that sound good?

Patient: Well, it does sound interesting and exciting. Now I just need to make time for all these amidst
my work schedules.

Nurse: To help you on that front, I would suggest you consult with our in-house counselor on time
management, and we also have a nutritionist who is available at this time on the 2nd floor. If you want, I can
get you an appointment with the nutritionist now and once you meet with him, you can come back here, and
I will help you get in touch with the counselor so that we can plan your routine well.

Patient: I guess I will do as you suggest.

Nurse: If you do not mind, I would like to add that you come for a review after 2 weeks of trying the
new regimen so that we can assess your improvement and do any modifications to it if needed. Can you do
that?

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 Patient: Yes.

Nurse: Thank you for listening to my suggestions patiently. We will get you in touch with the specialists
I mentioned earlier. I hope I have clarified your doubts.

Patient: Yes, you have been helpful. Thank you. I shall be on my way to meet with the nutritionist first.

Nurse: Thanks for your cooperation. Get well soon.

Patient: Thanks to you too. Good day!

13. Setting - Gastroenterology clinic.

Nurse – A 32-year-old male with irritable bowel syndrome is admitted for a day to be administered
with IV fluids for dehydration after diarrhea and food poisoning. He has a bulge in his vein, due to the IV
being administered with pain and wants it to be removed.

Task -

• Make adjustments or give temporary relief for pain and bulged vein

• Find out about his food patterns and foods consumed.

• Assure him that the bulging and pain will subside and there is nothing to
worry about it.

Patient – You are a 32-year-old male with irritable bowel syndrome. You are admitted for a day to be
administered with IV fluids for dehydration after diarrhea, and food poisoning. You have a bulge in your
vein, due to the IV being administered with pain and want it to be removed.

Task -

• Seek temporary relief for pain and bulged vein

• Tell about your food patterns when asked.

• Show that you are worried about the bulge in the vein. Be anxious about it as
they could have done it better.

Nurse: Good morning Mr. William, I am Rose, the registered nurse at this clinic. I will be attending you

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for the day. How are you feeling now?

Patient: Good morning Rose, I am feeling slight discomfort.

Nurse: That is unfortunate Mr. William, but I assure you that once we finish your IV fluid
administration, you will feel better.

Patient: I hope so. This IV line is causing me a little discomfort. Is it necessary for me to have this IV
line? Aren’t there any medications that I can take orally?

Nurse: Regrettably, this is the only mode through which we can successfully replenish fluids that you
have lost.

Patient: But is it necessary to. Haven’t I been here for quite some time?

Nurse: I understand your situation, Mr. William. Since you have been admitted here for dehydration,
along with severe food poisoning, it is highly recommended that we bring back the fluid level in your body.
Otherwise, it may lead to some other complications which might have undesirable effects on your body.

Patient: Oh. Then please look at the site of injection. I noticed a small bulge there. It is concerning.

Nurse: Please do not worry. The bulge has formed because of external fluid that is going into the vein.
There is no cause of concern. Please remain relaxed. To deal with the pain I will administer a mild painkiller
and I will gently massage the site of injection to reduce the bulge and regulate the flow of medicines inside.

Patient: Please do something. It is painful and unbearable.

Nurse: I can completely understand your discomfort. Please bear with us for some more time.

Patient: Hmm. I guess I have no other option.

Nurse: Thank you, Mr. William. Now I would like to ask a few questions regarding your condition to
report to the doctor, who is planning to revise the medications given to you and add a few new ones to help
you temporarily with dehydration and food poisoning. Is that okay?

Patient: Yes, that is okay. Please proceed.

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 Nurse: Thank you. Firstly, I understand that you are suffering from irritable bowel syndrome. Since
when have you been suffering?

Patient: I was diagnosed with irritable bowel syndrome in 2017 and have been having a really hard
time managing it. It does get difficult at times, specifically while traveling.

Nurse: Oh, I see. That means you travel a lot, I guess.

Patient: Yes, I am a sales manager, and my job requires me to travel at least 3 weeks a month.

Nurse: So, during your travel, do you cook your food, or do you eat from the place you stay?

Patient: I rarely get time to cook my food. I prefer to take-outs to save time.

Nurse: Have you ever noticed any changes in your bowel movement after these travels?

Patient: Now that you mention it, I remember every time I come back home from visits, I have a
severe stomach upset followed by diarrhea.

Nurse: Well, Mr. William, to summarise, you have informed me that you travel a lot and eat outside all
the time. Once you finish your travel and get back to your home, you suffer from diarrhea and stomach pain.
Am I correct? Is there anything that you would like to add to this?

Patient: Well, that is correct. But I want you to note that this time I did not eat anything out of the
ordinary.

Nurse: We will get to that point soon. Could you please tell me what types of food you consume while
on your trips?

Patient: I prefer non-vegetarian food items over vegetarian and specifically I prefer seafood.

Nurse: I see. Thank you for informing me about your preference. I would also like to know if you
prefer spicy and oily food over bland and simple food?

Patient: Of course, I prefer nicely roasted chicken and fish fry over anything else. Those are some of
the best food items which I can find wherever I go.

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 Nurse: That is useful information. Lastly, what was your last meal before you had this episode?

Patient: Hmm. let me think. Yes, I remember having chicken masala with boiled egg and chicken
biriyani at this small restaurant.

Nurse: Okay. So, we can safely assume that the hygiene at this restaurant was not at par with the other
restaurants. That is probably the reason why you had severe stomach pain with diarrhea and food poisoning.

Patient: Mostly that should be the case.

Nurse: Well, thank you for patiently answering my questions. The information you have shared is useful
to understand your condition and manage it efficiently. I will pass on this information to the doctor, who will
then decide the best course of action for your treatment. Is that okay?

Patient: Sounds good. But I am still concerned about this bulge. There is a nagging pain at the site, and
I am worried if it will lead to some other complications.

Nurse: Mr. William, you can be assured that there will be no such adverse effects of this bulge and
about the pain, it will gradually subside since I have administered painkillers now.

Patient: Then I hope this bulge is not permanent right?

Nurse: Absolutely not. Once we remove the IV line, the bulge will fade away on its own. You need
not worry much.

Patient: Sounds reassuring. Guess I will have to wait and observe.

Nurse: Yes Mr. William, I would like you to show a little patience towards the treatment. I hope I have
clarified your doubts. Is there anything else that you would want clarification for?

Patient: Yes. you have clarified all my doubts. No, I don't think I have anything at this moment. If
something comes up, I will let you know.

Nurse: Sure Mr. William. If at all you need help with anything, please do not hesitate to press the call
button. One of us will be with you immediately. Please take some rest now.

Patient: Sure. Thank you, Rose.

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 14. Setting - General clinic.

Nurse - A 45-year-old male with a history of malabsorption syndrome and symptoms of loss of
weight, giddiness, and diarrhea has walked in. He is irritated as the doctor hasn't arrived to see him. He
wants over-the-counter drugs for relief.

Task -

• Find out the patient's eating habits, to understand the diet pattern.

• Find out the medication history and convince him that you will arrange
alternatives.

• Be apologetic, that the doctor is late due to unavoidable circumstances.

Patient – You are a 45-year-old male with a history of malabsorption syndrome. You have symptoms
of loss of weight, giddiness, and diarrhea. You have walked in and are irritated, as the doctor hasn't arrived
to see you. You want over-the-counter drugs for relief and it is delayed since the doctor hasn’t come. Be
irritated that you didn't receive the treatment and medication that you need.

Task –

• Tell the nurse about your eating habits.

• Answer questions about medication history and express anger for the delay
in the doctor’s arrival.

• Initially be reluctant to hear explanation but eventually accept the nurse’s

apology.

Nurse: Good morning, I am Faran, a registered nurse at this clinic. I will be attending to you for today.
May I know what brings you here?

Patient: Good morning, I am Vinay, and I would like to meet the doctor immediately. I am not feeling
very well.

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 Nurse: Could you please tell me what are you feeling? Do you have any pain or are you feeling weak?
Could you elaborate?

Patient: I don’t know how to exactly pinpoint, but if you look at my medical records, you’ll know that
I have a history of malabsorption.

Nurse: Yes, I am having a look at it now. Have you been feeling better after your last visit with the
doctor? From a physical standpoint, you look weak as well.

Patient: Yes, I feel very weak, and I am having severe dizziness. For the past two days, I have been
having uncontrollable diarrhea. I feel completely exhausted and my stomach aches very much.

Nurse: I am sorry to hear that. Have you been eating well and on time? Do you tend to skip any meals
during the day?

Patient: Why do you ask so many questions. Is it necessary?

Nurse: I am sorry that you find this unnecessary, but we must know your current state of health to deal
with this condition proactively. Else, we might face certain unwanted consequences.

Patient: Oh okay. I eat until I am full, but then I vomit everything that I have eaten. Also, I am in pain
all the time. Can I meet the doctor now?

Nurse: Okay, Thanks for the information. I would request you to wait for some time as the doctor is
occupied with another emergency case. I understand from your medical history that you have recently been
prescribed medicine to help improve your appetite and nutrient uptake and I believe you need a refill. Am I
correct?

Patient: Yes, but this medication is making me even more nauseous and dizzy. Is that the case?

Nurse: I don’t think that is normal. I strongly recommend you to wait and consult with the doctor
before getting your prescription refilled.

Patient: What do you mean it is not normal? Why was I given this medication in the first place if it
weren’t normal?

Nurse: I understand your urgency and discomfort. However, the medication prescribed to you usually
does not have any side effects. Only after administration of the medications will we know if it suits an
individual or not. Now that we have seen that the medication has caused some side effects, I assure you we
will replace the medicines and give you an alternative that suits you better.

Patient: And why am I being made to wait so long. Where is the doctor? Can't some other doctor
attend to the emergency cases?

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 Nurse: Please bear with us for some more time. Most of the doctors are away at an international
conference and we are currently short-staffed. I sincerely apologize for the inconvenience caused. The
doctor was urgently called as there was an accident case that was brought a while ago and I will inform the
doctor right away about you so that he looks at your case right away.

Patient: Why are you giving so many reasons?

Nurse: I can see that you are angry about the current situation. But please be Patient and let us take
care of you. It won’t take more than half an hour before the doctor comes to attend. In the meantime, can I
offer you something?

Patient: It looks like I must wait. Well, it will be good if you can give me some place to lie down as I
feel terribly exhausted.

Nurse: Definitely, Mr.Vinay. If you please follow me, I will take you to the emergency ward, where we
have beds so that you can rest until the doctor arrives.

Patient: Thank you. Please hurry up and inform me once the doctor arrives.

Nurse: I assure you that I will personally come and get you once the doctor is free to consult.

Patient: Thank you.

15. Setting - Psychiatry clinic.

Nurse – A 36-year-old female with complaints of OCD, depression, and anxiety has come for a
consultation. She has been going through a divorce and has been highly stressed. She has been on anti-
anxiety medicines. She is rude to answer any personal questions.

Task-

• Explain why you are asking for personal details and why it is important to
answer.

• Be supportive of her feelings and understand her thoughts, life struggles, and
the severity of her symptoms.

• Find out if she has been following the prescribed advice and medication.

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 Patient – You are a 36-year-old female with a complaint of OCD, depression, and anxiety. You have
come for a consultation. You are going through a divorce and have been highly stressed. You have been
on anti-anxiety medicines. You are rude to answer any personal questions.

Task-

• Be rude and tell that you don’t want to answer any personal questions.

• Gradually express feelings and thoughts on personal life struggles and the
severity of your symptoms.

• Explain you were not able to follow the prescribed medication properly.

Nurse: Good morning, I am Nancy, the nurse on duty in this clinic today. How may I help you?

Patient: I would like to consult with a psychiatrist.

Nurse: Sure. Can I have your name?

Patient: I am Stella.

Nurse: Hi Stella, can you give me a description of how you are feeling?

Patient: I was initially diagnosed with OCD associated with depression and anxiety. My previous
psychiatrist had put me on anti-anxiety medication.

Nurse: Thank you for the information. If you don’t mind, can I ask a few personal questions about
your life?

Patient: What does my personal life have to do with OCD and depression? Isn’t the information which
I have given sufficient?

Nurse: As this is the first time you are visiting this clinic it is the standard procedure to take a complete
history of the patient. As you informed me that you have a history of OCD and depression associated with
anxiety and that your previous psychiatrist has put you on anti-anxiety medication, it will only be useful for
the consulting doctor to understand your situation better. We request your complete cooperation in this.

Patient: Hmm. But I don’t understand how my personal life will help you diagnose my mental
condition.

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 Nurse: If you don’t mind, I can explain that to you.

Patient: Yes, proceed.

Nurse: Thank you. To begin, a person’s personal life greatly impacts their mental health as they spend
most of the time with their loved ones. This influences social behavior as well. Since you have OCD, it must
have manifested due to some suppressed anger or any uncomfortable emotion. Only when we understand
the underlying emotion we can take the right course of action.

Patient: All these sounds good but what do I have to tell more than this?

Nurse: You can help me by answering a few questions.

Patient: Okay

Nurse: Firstly, can you tell me how many people are there in your family?

Patient: I live with my twin daughters and a son.

Nurse: How old are they?

Patient: My daughters are 15 years old, and my son is 13 years old.

Nurse: Is there something that has recently changed in your life?

Patient: Yes, I am going through a divorce from my 18 years of married life.

Nurse: Oh, that is unfortunate. Moving on. Do you work or are you a homemaker?

Patient: I work as a Senior Manager in a financial institution.

Nurse: On an everyday basis, how do you feel about interacting with people?

Patient: I hate interacting with people. Whenever I am forced to interact with anyone, I try to keep it
short and brief and get over it as soon as possible. If such conversations can be avoided, I try to ask some
of my juniors to deal with the interactions and I just review their inputs and report them to my boss.

Nurse: I am sorry that you feel that way towards people. But is it everyone in general or is it anyone in
particular?

Patient: I feel an aversion towards human beings in general.

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 Nurse: That’s unfortunate. Do you have thoughts about suicide or anything of that nature?

Patient: Right after we filed for a divorce, I was so broken, and I had thoughts of taking my own life
but my situation and my children reminded me of my responsibilities and purpose in life that I have never
acted upon it until now. Nor do I plan to act on it anytime soon. That is probably why I have come here
today.

Nurse: Good. One last question. How long has it been since you were diagnosed with OCD
depression and anxiety?

Patient: It has been almost 3 years since I have been going for therapy, but I haven’t gotten any better.
My employer forced me to consult with this clinic as I have been aggressive towards my colleagues at work.
Hence, I was given a month’s paid leave and advised to see a therapist and get my emotions sorted before I
returned to work.

Nurse: Thank you for sharing all the necessary information with me. Have you been taking anti-anxiety
medicines regularly?

Patient: Some days I forget to take them. Some days I refrain from taking them as it makes me sleepy
and exhausted for the day. I also feel nauseous when taking that medicine. So, I have restricted the usage of
medicines only on an emergency basis.

Nurse: Was this change suggested to you by your doctor or did you decide on your own?

Patient: My doctor had advised me to take them every day until further review, but I did not go back
to her after a few sessions. So, I have modified the dosage according to my convenience.

Nurse: As a nurse, it becomes my duty to advise on the ill effects of altering the dosage of certain
psychotherapeutic medicines. That includes but is not limited to nausea, vomiting, sleepiness, and disinterest
in everyday activities. When we alter the medications without regulation, mood swings can happen
drastically leading to increased suicidal tendencies.

Patient: Oh, I did not know that. I guess I must be more cautious while dealing with these medicines
then.

Nurse: Yes. I am glad that we had this conversation. I can now brief the doctor about your condition,
and he will plan a suitable treatment module suiting your needs and comfort.

Patient: Sounds good. When can I meet the doctor?

Nurse: He is currently with a patient. Once his session is over, I will take you to him. Is that okay?

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 Patient: Yes, thank you.

Nurse: Is there anything else?

Patient: No.

Nurse: Okay. Please be seated.

Patient: Ok thanks.

16. Setting- Psychiatric clinic.

Nurse – Tara a 28-year-old female with a history of depression, seems to have a loss of interest in
everything during the therapy session. She hasn't followed any advice or prescribed medication.

Task-

• Discuss her condition and the importance of the regimen.

• Find out reasons for improper regimen.

• Offer solutions to help her follow a proper routine.

Patient – You are Tara a 28-year-old female with a history of depression. You seem to have a loss of
interest in everything during the therapy session. You haven't followed any advice or prescribed medication.

Task-

•Insist that you don’t have interest in the therapy session and on request try to
cooperate.

•Give reasons for improper regimen.

•Ask for solutions to be on track with your routine and lifestyle.

Nurse: Good evening I am Anna, a registered nurse in this clinic. How may I help you?

Patient: I am here for my therapy session.

Nurse: Well, we shall begin your session once you tell me your name.

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 Patient: My name is Tara.

Nurse: Hello Tara. How are you today?

Patient: I am fine.

Nurse: How was your day?

Patient: It was good.

Nurse: Can you describe it for me?

Patient: It was a typical day. There’s nothing to explain.

Nurse: Well, I would like to know what you do during the day. Can you at least give me a brief
description?

Patient: I am not interested in sharing it with anyone. It was a boring day.

Nurse: Hmm. Okay then. You can tell me whatever you feel like sharing.

Patient: Well, there is nothing to share. I just want to get over with this session and go home and sleep.
I am tired.

Nurse: To be so exhausted what did you do Tara?

Patient: I just had my regular day at work. Does that answer satisfy you?

Nurse: I am not asking for my satisfaction. I want you to talk with me so that we can relieve a little
stress that you are carrying around.

Patient: I am not stressed. I am fine.

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 Nurse: Ms.Tara, I sense your disinterest in attending these sessions, but I request you to cooperate
with me here and help me out a little bit so that we can work together to get you better soon. Only if I have
your cooperation we can finish this session at the designated time, otherwise, the session will keep
prolonging until you open up to me. Do you follow?

Patient: Oh god. I have no interest in anything. Why don’t you understand that?

Nurse: In anything meaning what are the things, Ms.Tara?

Patient: Anything and everything bores me. I don’t find joy in anything. I feel that I am just existing for
the sake of it. I eat because I must survive. I interact with people because it is a part of my job. I need this
job.

Nurse: Please continue, I am listening.

Patient: Phew! I feel exhausted most of the time. No one wants to talk with me as I am silent or lost in
my thoughts.

Nurse: What are your thoughts about?

Patient: Most times, I think of different ways to end my life. Some days I think of ways to run away
from this place.

Nurse: So why are you feeling this way? Have you tried doing the meditation exercise we discussed in
the last session?

Patient: No

Nurse: Why? Is there any reason for not doing it?

Patient: Overall, I don’t like to do anything.

Nurse: Can you explain?

Patient: Most days I just sleep during my free time. When I am at work, I am lost in thought, or I am
held up with meeting deadlines, so I don’t find the time there. At home, I just turn on the television and stare
without following any content that is playing. Other than that, I browse through social media and wile away

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whatever little free time I get. So, I haven’t had time to sit and practice all the methods we discussed in the
last session. Also, I guess I lost the document that you had provided. Hence, I did not know where to begin.

Nurse: I am sorry to say this Ms.Tara but listening to your reasons, I understand that you have no
interest in getting better. It is a very toxic trait to possess, and we need to get rid of it immediately. We can
work on your betterment only if we have your complete cooperation. I hope you understand that you are
paying a lot of money to attend these personal sessions. I would expect you to at least give it a try and work
on your self-development. Anything will work only if there is an equal effort from all the parties involved. Do
you understand me?

Patient: I do understand all the aspects involved but I don’t find the energy or enthusiasm to do
anything. How can I bring enthusiasm into all these activities that you mentioned?

Nurse: I am glad you asked that. The best and easiest way to deal with your situation effectively
is by taking up a hobby and concentrating on it. Concentration will help in keeping your mind
focused on one thing and not let it wander. Once that works out, we can focus on meditation and other
activities that help you keep your mind occupied. The takeaway message here is not to leave your mind
empty. As the saying goes ‘an empty mind is a devil’s workshop’. We must work on slowly building our
relationship with the world. That way you will also feel comfortable around your social circle and not feel
detached all the time. Are you with me? Shall I proceed further?

Patient: Yes, please.

Nurse: Thank you. Further, you can try joining a few classes like Zumba, yoga, or dance classes that
will provide you with an opportunity to interact with many new people. This will aid in dealing with your
social anxiety as well. Can we work on that in the coming few weeks?

Patient: Whatever you have said sounds exciting. I am looking forward to implementing at least a few
of these immediately.

Nurse: Thank you for showing enthusiasm towards getting better. Is it okay if we have our next session
in a month?

Patient: Sure, see you next month.

17. Setting- Psychiatric clinic.

Nurse – You are speaking to a 45-year-old man who has come for a review. He has been diagnosed
with a history of bipolar disorder. The patient is on anti-maniac medication and hasn't followed the
prescribed medication and advice properly. The Patient has worsened and has adverse symptoms.

Task-

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 • Discuss his condition and the importance of regimen with the patient.

•Find out details for improper regimen.

•Offer suggestions to help him follow a proper regimen and advice

prescribed.

Patient – You are a 45-year-old man. You are diagnosed with a history of bipolar disorder. You are on
anti-maniac medication and haven't followed prescribed medication and advice properly. You have
worsened and seem to have adverse symptoms

Task-

• Cooperate to discuss your condition and try to understand the importance of

the regimen.

•Give details for improper regimen

•Assure to follow the solutions offered seriously for a proper regimen.

Nurse: Good afternoon. I am Renu, a registered nurse at this clinic. Good to see you, Mr.Suraj. How
are you doing?

Patient: I am doing better. But I had a few ups and downs recently.

Nurse: Oh! Sorry to hear that. At your own pace, could you tell me what happened recently?

Patient: Well recently I have been feeling much lower than usual and the number of times I have
laughed has almost become negligible. I feel the medicines given aren’t working at all.

Nurse: Is that so? Well, I will quickly have a look at your case history.

Patient: Sure

Nurse: It looks like you have been prescribed with heavy anti-maniac medicines which usually should
work. I wonder why they haven’t worked for you. Have you been taking the medicines regularly?

Patient: Well, I have been taking these medications on and off. I don't take them regularly.

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 Nurse: Can you tell me why you haven't been taking them regularly?

Patient: I feel sometimes the medications make me too drowsy. That is the reason why I have not been
taking it regularly. Sometimes I feel very happy, so I don't feel the necessity to take the medication.
Sometimes when I feel really low, I take one or two pills at a time and abstain for a long time. Sometimes
what happens is, I just give this medicine to one of my friends who is also suffering from the same condition.

Nurse: That is unfortunate. That is not how it usually works. Never give your medications to another
person who has not been diagnosed by a medical practitioner. I strongly recommend that you ask your
friend to visit a psychiatrist to get his medication and I strongly suggest you stop giving away your
medications to anyone at your own will and accord.

Patient: What do I do? Sometimes I do not feel like taking this medication. Is there any alternative for
that?

Nurse: I understand your apprehension, but I strongly recommend that you consult with the doctor and
then plan a new course of action. Before we move further can I ask you a few questions?

In brief, can you tell me your regimen?

Patient: In the morning, I wake up and have a cup of coffee which keeps me going for almost the
entire day but just for the sake of eating I consume a little fast food that I get from the nearby food truck.
According to the doctor who I consulted last time, he told me to work on my social skills and interact with a
lot of people. I also was advised to join certain self-help groups to help deal with the bipolar disorder with
which I have been diagnosed.

Nurse: Ok please continue.

Patient: Apart from this I usually spend most of my time researching something or the other on the
Internet. Along with the doctor advising me to interact with a few people, he also advised me to join certain
classes which might help me keep myself distracted throughout the day.

Nurse: Well, have you been doing those activities which the doctor advised?

Patient: Honestly, I don't find the energy in me to follow everything the doctor says. I usually find
myself very drained by the end of the day, so I just call it a day and go to sleep.

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 Nurse: Oh, that sounds like a bad practice. What other suggestions did the doctor give you in the last
session?

Patient: The doctor also advised me that I work on controlling my emotions and not letting them waver
so drastically. Sometimes, I feel very happy, sometimes, I feel completely drained out and exhausted. I feel
like throwing out things and locking myself up in a room. I do not even feel like eating anything during my
down phases.

Nurse: I am so sorry to hear that. What have you been doing to manage that?

Patient: I usually do not do anything to manage whatever I am suffering from. I try to stay silent and
lock myself in the room. I usually isolate myself from all the other family members so that I do not hurt them
during my lows. I tend to forget what I said or did during those times. When I am happy, I try to entertain
them to the maximum possible limit, and I feel that they understand my drastic mood changes. This has
helped me a lot in dealing with my emotions effectively.

Nurse: I appreciate your family's cooperation in dealing with your condition. But I would strongly
advise you to follow the regimen more sincerely. Can we do that?

Patient: Tell me how do I deal with this kind of unforeseen situation?

Nurse: To begin with I would ask you to keep or maintain a journal that will record all your mood
swings and how you feel on an everyday basis. Further, I would also like you to keep track of what are the
things that trigger your mood swings. Once you have taken note of all these things it will be easy for you to
analyze what triggers your mood swings and what helps in maintaining your emotions under control. Once
we have taken note of all these factors then I feel it should be a cakewalk for you.

Patient: It sounds easier when you say it like that. But most of the time I do not find the energy within
me to even lift a pen or pencil to make a note of all the things that you said.

Nurse: When you are in such low phases you can use recording apps that are available on your
smartphone to log in your feelings regularly, whenever you feel better you can then enter them into the diary.
Am I clear so far?

Patient: Yes, I can understand what you are saying.

Nurse: Shall I continue?

Patient: Yes, you can.

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 Nurse: Further there are very small things that will help you follow your regimen regularly. One such
thing would be to talk to someone who you trust yourself with, who does not judge you for whatever you
say. Do you have someone in your life like that?

Patient: Yes, I do have my best friend who also works as a counselor in the local School.

Nurse: Well, there you go. You have your living diary who will record everything for you and give you
immediate or temporary solutions to deal with your mood swings. Inform your friend about your condition
so that they will be able to be more empathetic towards your condition. We do not want to take them by
surprise, do we?

Patient: Of course, I will talk to my friend once I get off this session.

Nurse: I would like to add one more thing before we wind up our session.

Patient: Please tell me what is it?

Nurse: I would recommend you join certain groups Where a lot of people socialize together to share
their ups and downs. There are a lot of self-help groups for people suffering from bipolar disorders. You can
find them on the Internet. If you have trouble finding them, please feel free to contact the reception of the
hospital. We have a lot of pamphlets that inform about local self-help groups that cater to different needs
according to the Patient's requirement.

Patient: Sure, I will check with the receptionist and get in touch with one such group that caters to my
needs.

Nurse: I am so glad to hear that, is there anything else that I can help you with?

Patient: Well, I guess that will be all.

Nurse: It was good interacting with you. We shall meet again in a month after you have incorporated all
the suggestions that we have discussed. I do not expect you to do all of them in the coming month, but I
would highly appreciate you trying to do at least one or two of the above-mentioned activities.

Patient: I will try my level best. I hope it works this time.

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 Nurse: We do hope so too. Looking forward to the next session in the coming month. Have a great
day.

Patient: Thank you.

18. Setting - Obstetrician and gynecology clinic

Nurse – A 30-year-old female comes with a complaint of abdominal pain after intrauterine device
(IUD) insertion. She has had an insertion of Mirena. She has a complaint of abdomen pain and discomfort.
So, asks for removal due to the existing pain. The patient had the intrauterine device insertion before four
days and is anxious and panics that it has caused the abdominal pain.

Task –

Convince that it is normal for the patient to have pain and discomfort for the first few weeks
or months because it will take time for the body to adapt to the new device.
Advice to take the analgesic which the doctor has prescribed. Convince that the pain will
settle down and she can come back if the pain exists.
Explain the drawbacks of hormonal contraceptives and tell why IUD is better compared to
it.

Patient - You are a 30-year-old female who comes with a complaint of abdominal pain after
intrauterine device (IUD) insertion. You have had an insertion of Mirena and have a complaint of abdomen
pain and discomfort. You demand to remove it due to the existing pain. You apparently had the intrauterine
device insertion before four days and are anxious and panic that it has caused the abdominal pain.

Task –

Explain your pain and discomfort to the nurse. Be adamant to listen to the nurse.
Demand the nurse to remove it as soon as possible. Express that you are anxious and
anticipate that the intrauterine device insertion could have caused the abdominal pain.
Be reluctant to follow doctor’s prescriptions. Finally, try to comply with the nurse’s
instructions.

19. Setting - Suburban clinic

Nurse - A 12-year-old boy with a complaint of difficulty and pain in swallowing since last night has
been bought by his mother. On examining him, you find out that a fishbone is stuck in his throat. Refer to the
ENT specialist. The mother is panicked and asks why you cannot treat him and why an ENT must be
referred. The mother is anxious and does not agree to go and see an ENT specialist. She asks if basic first

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aid and treatment cannot be given here.

Task –

Explain it is necessary to go and see an ENT specialist because it might bleed if the bone
needs to be removed. And it can cause adverse effects if it bleeds.
Examine the position of the bone and explain where it is struck and why an ENT
consultation is needed.
Pacify the mother and direct them to an ENT specialist.

Patient – You are a mother of a 12-year-old boy. You walk in with your son as he is having difficulty
and pain in swallowing. On examining him, the nurse finds out that a fishbone is stuck in his throat. The nurse
suggests that you take your son to an ENT specialist. You panic and ask why the nurse cannot treat him here
and why it is necessary for an ENT to be referred. You are anxious and you do not agree to go and see an
ENT specialist. You ask if basic first aid and treatment cannot be given here.

Task –

Ask why it is necessary to go and see an ENT specialist. Show disinterest to take your son
to an ENT. Seek first aid service to be provided for your son.
Cooperate with the nurse to examine the position of the bone.
Ask where it is struck and understand why it is necessary to see an ENT specialist.
Initially be inflexible but eventually agree to consult an ENT specialist.

20. Setting - Suburban clinic.

Nurse- A 45-year-old man post-COVID vaccination has come for a follow-up. He has come two to
three days after vaccination and has mild symptoms of fever, headache, and body pain. The patient is
anxious if the vaccination has caused any adverse reaction and is worried.

Task –

Convince him that it is common to have fever, headache, and body pain.
Tell him that he needs to come if he has any symptoms of giddiness, allergic reactions like
itching, vomiting, etc. that these are not very common to have symptoms post-vaccination.
Give instructions that he can schedule the next dose of vaccination on the website.

Patient- You are a 45-year-old male who has walked in post-COVID vaccination who has come for a
follow-up. You have come two to three days after vaccination and have mild symptoms of fever, headache,
and body pain. You are anxious if the vaccination has caused any adverse reaction and are worried.

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 Task –

Explain to the nurse that you have a fever, headache, and body pain.
Express your fear that this could be causing severe problems.
Ask for details about the second dose of vaccination.

21. Setting- Emergency

Nurse -A 50-year-old male walks in with a complaint of chest pain and asks for pain relief medication.
The patient is very lethargic about his health and feels that it is okay to just have a painkiller, which might
subside the pain. Speak to the patient and ask questions to understand the symptoms. Explain why self-
medication is dangerous and the importance to consult a doctor.

Task –

Ask about the patient’s medical history to understand the condition of the patient.
Convince the patient for ECG and other cardiac marker tests.
Explain why it is important to take the tests
Explain why the medicine cannot be given without the test, without understanding the exact
health condition.

Patient – You are a 50-year-old male. You walk in with a complaint of chest pain and ask for pain
relief medication. You are very lethargic about your health and feel that it is okay to just have a painkiller,
which might subside the pain for the time being. Be reluctant to see a doctor. State that temporary pain relief
is sufficient for you and disagree to take the tests. Later after understanding the importance of it, comply with
the advice.

Task –

Answer the questions of the nurse about your medical history and demand a painkiller
immediately.
Argue you don’t want to take the tests.
Be hesitant to listen to advice.
Make a strong argument when demanded to comply with the procedure.

22. Setting - Preoperative ward

Nurse - A 60-year-old female with a diabetic foot ulcer that has progressed to necrosis (death of body
tissue) is admitted and is advised for removal of the infected part. The patient is very anxious about the
removal. She believes that it might make her immobile with difficulty to carry her day-to-day routines. She
doesn’t want to undergo removal as she fears of getting disabled. Explain the importance of getting it

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removed and comfort her that she will not lose her mobility.

Task –

Explain why it is necessary to undergo removal or amputation of the infected part.

Explain the importance of amputation and the adverse effects which can come if it is not
done.
Convince that normal life will not get disturbed, post-amputation.
Ask if the patient has any other adverse health complications.

Patient – You are a 60-year-old female with a diabetic foot ulcer that has progressed to necrosis. You
are admitted and are advised for removal of the infected part. You are very anxious about the removal. You
believe that it might make you immobile with difficulty in carrying your day-to-day routines. Say you don’t
want to undergo removal. Explain your fear of getting disabled.

Task –

Show that you are very anxious about the removal.

Express your fear to the nurse that you don’t want to proceed with the amputation.
Ask questions if the procedure will affect your daily routine and mobility.
Try to understand the importance of the procedure and answer the questions of the nurse.

23. Setting – Emergency

Nurse - A 24-year-old male with a snake bite in the left leg walks in. He has a complaint of swelling of
limbs. The swelling has progressed to compartment syndrome. The doctor has advised a fasciotomy to
relieve pressure between the tissues. The patient is not aware of what he's going through and the procedure
that is advised to him. He is anxious if it can cause any other fatal reactions.

Task-

Explain what compartment syndrome is. (That is the swelling up of tissues due to internal
bleeding).
Explain why it is important to undergo a fasciotomy and what it is. (explain that it is a minor
procedure where tissues are cut to relieve the pressure)
Explain the importance of fasciotomy that it reduces the blood flow which is a complication
that might arise.

Patient – You are a 24-year-old male who walks in with a snake bite in the left leg. You have a
complaint of swelling of limbs. The swelling has progressed to compartment syndrome. The doctor has
advised a fasciotomy to relieve pressure between the tissues. You are not aware of what you are going
through and the procedure that is advised to you. You are anxious if it can cause any other fatal reactions.

Task-

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 Be nervous and ask questions about compartment syndrome.

Ask questions about fasciotomy and express your fear that these could cause any fatal
reactions.
Express your pain to the nurse and seek immediate action for your condition.

24. Setting - General medicine clinic

Nurse – A 40-year-old male with hypertension walks in for a review. On examining him you find that
his blood pressure is high. The Blood Pressure is 180 Bar 90 mm/Hg. Question him if he has taken his
medication, try to understand his diet and lifestyle. He is very lethargic about his health and eating patterns.
He doesn’t understand the dangers of hypertension and the complications that may arise.

Task –

Explain the dangers of hypertension and comfort the patient that this could be controlled
easily.
Ask questions to understand the patient's diet and habits.
Advise the diet he could follow such as green vegetables, fruits, protein-rich foods, whole
grains, and a balanced diet.
Suggest relaxing activities to maintain the blood pressure level in a normal range.

Patient – You are a 40-year-old patient with hypertension. You walk in for a review. After
examination, the nurse finds that your blood pressure is high. The Blood Pressure is 180 Bar 90 mm/Hg.
You work as a teacher and live with your family. You have a peaceful life, so you wonder why your blood
pressure level is high. You would like to seek assistance and advice from the nurse. Answer questions
patiently and try to understand how to make lifestyle changes for your condition.

Task –

Tell the nurse you are frustrated about the BP level, and you don’t know why it is increasing.
Answer questions about your diet and habits.
Listen to the nurse’s advice.
Question about more suggestions to control the blood pressure level.

25. Setting- general medicine dermatology clinic

Nurse - A 18-year-old male who is panicked and anxious with a complaint of micturition (painful,
burning urination) has come for a consultation. He admits that he has had unprotected sex. The patient has a
complaint of a burning sensation during urination. The patient had unprotected sex two days ago and is
frustrated why he is undergoing this sensation. He is anxious if he has contracted anything due to unprotected
sex.

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 Task-

Convince him that it is nothing to worry about. Try to reduce the anxiety of the patient.
Suggest taking the required tests to understand the reason for the symptoms.
Advise the patient to take safety measures by using other contraceptive methods which are
safe and hygienic.

Patient – You are an 18-year-old male who is panicked and anxious with a complaint of micturition,
you have come for a consultation. You admit that you have had unprotected sex. You have a complaint of a
burning sensation during urination. You had unprotected sex two days ago and are frustrated why you are
undergoing this sensation. You fear if you have contracted an infection and panic.

Task-

Tell your condition to the nurse and express how frustrated you are about micturition.
Ask the reasons why you are going through this and ask questions about the tests you need
to undergo.
Listen to the advice of the nurse and assure to follow them in the future.

26. Setting - Obstetrician gynecology in-patient ward

Nurse - A 24-year-old female is anxious about her three-day-old female child who has a complaint of
tongue sticking out to the lower jaw. The doctor has diagnosed it as a tongue tie. The mother is anxious
about the condition of the baby. She fears if the baby’s speech and normal lifestyle will be affected and is
anxious about it.

Task –

Convince that it is common and there is nothing to worry about.

Suggest waiting till the baby turns one to two years old and tell that it will go away usually
around that age.
Pacify the mother and tell her that if it is persisting, they can come and undergo a minor
surgery at that time to heal.

Patient – You are a 24-year-old female who is anxious about your three-day-old female child who has
a complaint of tongue sticking out to the lower jaw. The doctor has diagnosed it as a tongue tie. You are
anxious about the condition of your baby. Be anxious if your child’s speech will get affected. Ask questions
to understand the condition and treatment options.

Task –

Be nervous and explain the condition of your child to the nurse.

Argue that you cannot wait so long as you are afraid that this could affect your baby’s

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 tongue severely.
Ask questions to know what can be done if it persists after one year. Calm down when the
nurse pacifies you with proper assurance.

27. Setting - Suburban clinic

Patient- You are a 25-year-old mother, who walks into the suburban clinic with your 10-week-old
baby. You missed the vaccination in the sixth week and are concerned. Ask what you can do to reschedule
the missed vaccine for this month. Question to understand if it wouldn’t be a problem.

Task-

Ask the nurse if missing a vaccination schedule is okay and explain why you missed the
schedule.
Ask if something can be done to rectify that presently and how to keep a track of the
schedules.
Enquire about the next dose schedule.
Be concerned about the possible side effects that might surface in the baby post-vaccination.
Insist the nurse to provide an emergency use medicine in case your child develops a
temperature

Nurse - A 25-year-old mother brings her 10-week-old baby and tells you that she missed the sixth-
week vaccination of her child. She asks if it is okay and what can be done to reschedule the vaccination for
the current month.

Task-

Tell her it is okay. Ask her to continue the regular vaccination schedule from now on.
Give instructions for when the next dose needs to be scheduled.
Give advice on symptoms like fever and body pain, which might be common for babies after
vaccination.
Advice that she can give the paracetamol drops prescribed by the doctor in case the baby
develops temperature.

28. Setting- General medicine clinic

Patient- You are a 54-year-old female who is diagnosed with high blood sugar. You walk into the
general medicine clinic for a follow-up visit. The attending nurse wishes to examine you.

Task-

Be concerned about your health and sugar levels.

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 Listen to the nurse’s advice on the dangers associated with high blood sugar.
Ask the nurse for an appropriate diet to control and maintain a healthy lifestyle.
Further, be concerned if diet alone would help or if there is something else that you can do.

Nurse - A 54-year-old female with high blood sugar has come for a follow-up visit. Examine the
patient's vitals and check her reports. You come to know that her blood sugar is still very high.

Task –

Advise the patient on the dangers of high blood sugar.

Advise her on a diet that is good for her health condition, such as low carbohydrates diet
with green leafy vegetables, a sugar-free diet with high proteins.
Suggest her to do mild to moderate exercises like walking.

29. Settings - Suburban clinic

Patient – You are a farmer who is 75 years old. You were diagnosed with arthritis. You walk into a
suburban clinic as your condition has worsened. You do a lot of manual labor, you are not able to take time
off from work. Ask questions and try to understand your condition. Be reluctant to follow advice on rest, as
your daily work involves a lot of physical activities. Rather ask for alternative suggestions.

Task –

Be worried as to what this condition is and ask the nurse to elaborate.

Answer the nurse’s questions.
Inquire about a proper diet for getting better.
Listen to the advice given by the nurse.
Be reluctant to take the advice as most of your work involves heavy lifting and long walks.
After a clear explanation agree to try to avoid heavy labor.

Nurse – A 75-year-old male who is a farmer walks in with a diagnosis of arthritis he is unsure about
the severity of his condition. The patient does a lot of physical activity as a part of his work which has
caused his symptoms to progress. Question him to understand his diet and lifestyle. Advise him on necessary
precautions that can prevent his condition from worsening.

Task-

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 Explain what his condition is, to make him understand it better.
Ask him the kind of diet he follows.
Advise him on a low carbohydrate diet with green leafy vegetables and high protein which is
safe and beneficial for him.
Suggest that it is good for him to reduce carrying weight and walking for a long distance and
time.
Emphasize that avoiding physical labor at least for a short time, will be the only way to
prevent the condition from worsening.

30. Setting - Suburban clinic

Patient – You are the mother of a 6-week-old infant who is due for a vaccination. You are waiting for
a review post-vaccination to enquire about the key points to be taken care of for the next few days. Your
child has a history of drug allergies. Ask if this is a cause of concern post-vaccination.

Task –

Ask the nurse in charge about the next vaccination due date.
Be anxious about the possible side effects following the current vaccination. Ask for
instructions on how to take care of the baby if she develops any symptoms.
Clarify the doctor’s instructions in case the baby has a fever.
Insist on clarifications regarding the prescribed dosage of medications.

Nurse - A mother has bought her six-week-old baby for vaccination. She is waiting for review
following the vaccination to ask for details about the next vaccination and the symptoms that the baby might
have along with measures to be taken care of for the next few days. She is concerned about adverse side
effects and reactions as her baby has a history of drug allergies.

Task –

Give instructions that the next vaccination will be on the 10th week and inform the date that
she can come.
Reassure the mother on the safety of vaccinations and harmless side effects.
Advice that It is common for the baby to have fever and body pain. Explain that she can
follow the instructions given by the doctor in case the baby has a fever in the next two days.
Explain the dosages prescribed by the doctor.

31. Setting – Obstetrician & gynecologist clinic

Patient- You are a 35-year-old female who has delivered your third baby and is about to be
discharged. An OBGYN nurse is visiting you to discuss a few important details and measures before
discharge on instructions you need to follow.

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 Task –

Answer the questions asked by the nurse.

Listen to her advice on family planning.
Be reluctant to take up family planning and ask for more clarification.
Express your concern about infections and other side effects and check for available
alternatives.
Be hesitant to undergo another procedure as all your deliveries have been without any
surgeries and express anxiousness over getting surgery done.
Be difficult to convince but eventually agree to the family planning option.

Nurse - A 35-year-old female nurse who has had her third baby delivered is waiting for review before
getting discharged. Promote family planning for her. Advice her on instructions to be followed post-
discharge. Get clarifications about the dosage of medications prescribed by the doctor.

Task –

Ask questions regarding her family planning idea and knowledge about it.
Present all the available family planning options to her.
Give reasons why it is a good option to have family planning. Like economic feasibility and
emphasize that it lacks side effects compared to oral contraceptives.

Explain other contraceptive methods that are available and advise on side effects of
hormonal contraceptives
Convince the patient to undergo family planning as soon as possible as having recurring
pregnancies might weaken the uterus and cause complications.
Reassure the patient that it is harmless and has no long-term effects.
Advice that the uterus might get weak as she has already had three deliveries
Stress on the effect of pregnancies on her health and family economy.

32. Setting- General medicine Ward

Patient – You are a 55-year-old male, who has been administered with a Covid-19 vaccine. You are
awaiting a review by the nurse in charge. You are suffering from pre-existing heart conditions and take blood
thinners for the same. You are concerned if you can continue your medications post-vaccination and are
anxious about it causing adverse side effects. Question the nurse to get clarifications on the same. Ask
instructions to follow post-vaccination.

Task –

Express anxiety to the nurse in charge.

Be concerned about the information circulating, on the adverse effects of vaccines in the
media.
Enquire about the probable side effects that you can anticipate over the next few days.
Ask if it is okay to continue your medications.

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 Pay attention to what the nurse says about the side effects and ask how they can be dealt
with.

Nurse -A 55-year-old male after taking a covid vaccine is awaiting a review. He conveys that he has
heart problems and is on blood thinners. He asks if it is okay to continue his medicine post-vaccination. He
is anxious that it might cause adverse side effects

Task –

Comfort the patient and listen to his concerns.

Reassure him that vaccinations do have side effects but are not very adverse.
Advise him that he can continue his medicines.
Inform that it is common to have fever and body pain for the next few days.
He can take paracetamol or a painkiller in case he has body pain.

33. Setting - General medicine clinic

Patient- You are a 23-year-old male admitted at the general medicine clinic for a dog bite. You are
worried about any serious reactions because of it. Be anxious and question the nurse on treatment and
adverse effects of the dog bite.

Task –

Be worried that you might be infected with the rabies virus.

Be unreasonably upset and restless.
Calm down only when the nurse offers information about the available vaccines.
Find out the advantages and disadvantages of vaccines.
Ask if there are any side effects of vaccinations.
Enquire about the expenses involved and due dates for each dose.

Nurse- A 23-year-old male who has had a dog bite walks in and tells that he has had a dog bite. He is
anxious that he might have any adverse reactions because of it. Answer his queries and calm him down.
Pacify him telling him that he will be alright and he needs to take the vaccine.

Task –

Calm the patient down.

Give immediate first aid and administer pain killer.
Advice on the availability of rabies vaccine.
Clarify the advantages and disadvantages of the rabies vaccine and emphasize its
importance.
Hand out the vaccination schedule to the patient. Advise him on the importance of adhering

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 to the schedule on the first, fourth, fourteenth, and twenty-eighth day from the day of the
incident.
Clarify the patient’s doubts.

34. Setting - Urology clinic

Patient – You are a 23-year-old female visiting the urology clinic. You have complaints of burning
sensation while urinating associated with bleeding. You had unprotected sex two days ago and are anxious
about the presenting symptoms that you are experiencing. Be nervous and anxious. Ask questions to
understand the reasons for your symptoms.

Task –

Be anxious and tell the nurse what happened.

Answer the nurse’s questions.
Be scared if you might have contracted some infection.
Ask about the safety measures that need to be taken during intercourse.
Ask clarifications about the tests prescribed by the doctor to rule out the possibility of
urinary infection.
Enquire if there is anything that you need to do after taking the tests.
Ask if you can continue the pain relief medication until the next review.

Nurse - A 23-year-old female walks in with a complaint of burning sensation while urinating. The
patient also has a complaint of bleeding while urinating. The patient admits that she has had unprotected sex
two days ago. She is anxious about the symptoms that she is experiencing and is enquiring about what needs
to be done.

Task –

Ask questions to understand her symptoms.

Explain the importance of safety measures to be taken during intercourse that is safe and
hygienic.
The doctor has advised her to take a few tests to rule out the possibility of urinary infection.
Advise her to come for a follow-up post getting the test results.
Suggest that she can continue the pain relief medication which is prescribed till then.

35. Setting - Post-operative recovery Ward

Patient-You are a 60-year-old male, you have had a metal implant inserted a few months ago following
a fracture. You have recently undergone surgery to remove the implant since your fracture has healed. You
are confused and do not remember where you are. Question the nurse to understand where you are and
recollect your memories.

Task –

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 Be confused and ask where you are.
Keep asking to see your daughter and insist that you feel cold.
Do not listen to what the nurse is saying and keep asking to see your daughter.
Listen to the nurse’s explanation.
Be difficult to console and be upset.
Calm down only when the nurse repeats the situation.

Nurse- A 60-year-old male who has had a fracture, followed by treatment with a metal implant
insertion a few months ago has undergone surgery to remove the metal implant on complete healing of his
fracture. The patient doesn't remember or follow where he is. He keeps saying that he is feeling cold and
asks for his daughter. He keeps repeating the same thing.

Task –

Calm down the patient.

Assure the patient he is in the recovery room post his surgery and is safe.
Examine his vitals.
Reassure him that his daughter is outside the recovery room, and he’ll be able to see her
once he is moved to the ward.
Repeat if necessary to make him understand.

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 10 GENERAL ETIQUETTES TO FOLLOW
DURING EXAMINATION
❖ Break the ice with the examiner before you start the test so that you get comfortable with
speaking to the examiner.
❖ Be confident in your posture and communications.
❖ Listen carefully to all the information that is conveyed in the question.
❖ Only if you listen carefully to what is the concern of the patient, you can address it by giving
proper solutions to it.
❖ Maintain a casual posture.
❖ Avoid rephrasing sentences.
❖ Avoid pauses, breaking sentences and again reframing them.
❖ Make sure you don't repeat the same words, more than once in a sentence.
❖ Avoid unprofessional hand movements.
❖ Maintain eye contact with the examiner. Do not see or focus on other things in the room, like fan
walls, etc.
❖ You can nod your head to show that you are understanding and getting the information of what
the examiner conveys or asks.
❖ It is okay to nod a few times to show them that you are following the conversation.
❖ Do not get distracted, to see the phone, or watch.
❖ Be positive with the patient by telling them that the doctors are skilled and they are in good
hands, etc.
❖ Take time to explain procedures.
❖ Listen and respond to the patient.
❖ Use professional choice of words to offer advice.
❖ Finish by summarising everything that you have spoken to them in the end.

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 11 LAST-MINUTE TIPS AND THINGS TO
REMEMBER.
1. Continue the conversation no matter what, or how the situation is.
2. Ensure to give a feel that you are capable of handling the situation.
3. Do not stop or pause to think.
4. When you feel uncomfortable about the conversation. Aim in keeping the conversation going, so
that the conversation doesn't come to a halt or pause in between.
5. Keep the patient comfortable to have a good rapport in the conversation.
6. Be prepared to comfortably respond to harsh conversations or situations where the patient is
rude or uncooperative.
7. Feel free to ask questions. This statement is for two things.

One is after you get your question card in case you have any doubts, in terms of the
question. You must clarify your doubts about the question with the examiner.

Secondly, questioning your patient. Even if they are not ready to respond when they are not
very cooperative, giving rude replies.

8. No matter how the patient is, do not hesitate to ask questions. As that is the nature of your job
and it also helps in keeping your conversation going.
9. In case you feel stuck in a conversation where the patient gives short replies or uncooperative
harsh/ rude responses. Frame and ask general questions regarding the case of disease or the
setting that is needed. This will help in progressing the conversation.
10. Be confident. Confidence gives a good feel to the examiner that you are capable of handling the
situation. Be confident to keep the conversation going. Listen fully to what the patient has to say.
11. Before you respond. Think and speak, but do not let your thinking create long pauses or breaks
in the conversation.
12. Even if you are in this scenario in real, you need to prove your ability to handle it in your
profession. So, this can also happen in reality. Hence, think from a practical perspective of how
the patient will feel and how you would address the same scenario.
13. Confidently use idioms and fillers. These will be helpful at different instances when you feel you
need time to think.
14. Using fillers and idioms can help to prevent grammatical errors caused by speaking without
thinking. Especially when you are not ready with the content, but keep going with the flow by
randomly giving a response.
15. Practice using sentence patterns with idioms or fillers to have a good framework of where and
how to use them in sentences
16. Use different types of sentences like simple sentences, adjective clauses, etc.
17. Even if you use fillers or idioms and phrases grammatical mistakes can happen. If you don't frame
your questions properly, or use them in the right manner. So, you must get comfortable with
using them in different types of sentences in the right way with practice.

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 ​1 2. GLOSSARY

1. Micturition – The action of urination.

2. Dose – A quantity of medicine taken.
3. Dosage – The amount or frequency of a dose.
4. Ache- Continuous or prolonged dull pain.
5. Amputation- Surgical removal of part of the body.
6. CBT – Cognitive behavior therapy.

(Therapy for depression and anxiety by changing the way you

think and manage)

7. Empirical treatment – Treatment given before

a diagnosis is made.

8. Seizure- Sudden uncontrollable electrical activity

between brain cells.

9. Ailments -An illness, generally referred to

a common one.

10. Rehabilitation -The process of restoring someone

to normal life after addiction or illness.

11. Endoscopy – Procedure to view internal parts.

12. Fasciotomy – A cut made to relieve pressure

developed between muscles.

13. Hemorrhoid- swollen vein or group of veins.

14. Malabsorption syndrome – Inability to properly

absorb nutrients.

15. Necrosis -Death of most or all cells in an organ or

tissue due to disease, injury, or failure of blood supply.

16. Compartment syndrome- increased pressure

within confined body space especially leg or forearm.

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17. Benign – non-cancerous.
18. Malignant – cancerous.
19. Anti-inflammatory – reduces pain swelling

and soreness.

20. Body Mass Index BMI – body fat measurement

based on height and weight.

21. Biopsy – tissue sample taken for testing purposes.

22. Hypotension – Low blood pressure.
23. Hypertension- high blood pressure.
24. Invasive – requires entering the body with an instrument.
25. Non-invasive – doesn’t require entering the

body with an instrument.

26. Inpatient – plan to stay in hospital.

27. Outpatient – consult and leave the hospital.
28. Lesion – a wound, sore, or cut.
29. In remission – the disease is not getting worse.
30. Acute – sudden (short duration)
31. Chronic – long-term or long duration.
32. Angina – pain in the chest related to the heart.
33. Gastro-esophageal reflux disease GERD – heartburn.
34. Cellulitis – inflamed or infected in the skin.
35. Epidermis – the outermost layer of the skin.
36. Neutrophils – the most common type of WBC.
37. Edema – swelling.
38. Embolism – moving blood clot.
39. Thrombus – a fixed blood clot.
40. Polyp – mass or growth.
41. Sutures- stitches.
42. Compound fracture – broken bone that protrudes

through the skin.

43. Comminuted fracture – broken bone that shatters

into multiple pieces.

44. Abscess- a tender fluid-filled pocked of tissue

due to infection.

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 45. Contusion – a bruise.

For Training and assistance Contact:

Wordsmith Training & Consulting

Mail: info@wordsmithimmigration.com

Phone number: 9972539448

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 ABOUT THE AUTHOR:

Shamini Mary is an internationally acclaimed OET trainer, entrepreneur, and

author. She has successfully coached 1000+ nurses across varied work
experiences to improve their communication skills. She has been recognized
specially for her skills in OET training by the Cambridge Language assessment.
She is the Director and OET speaking course specialist at Wordsmith Training and
Consulting LLP. Wordsmith is also listed as the leading institute for OET Training
in Bangalore.
She has been working on coaching individuals from different backgrounds in
terms of their language, soft skills, and communication in the English language for
more than 7 years. She has enabled several Nurses to crack OET with grade A/B
in their first attempt and pursue their dream jobs in dream locations. She is also
working on books in communication, based on different competencies and self-
help.
instagram handle: @shamini.mary
@wordsmith_consulting

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