MODULE ONE

PSW Foundations
Health and Wellness
• Health is “a state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity” (WHO)

• In recent years the definition also includes the ability to lead a

“socially and economically productive life”

• Disability and illness affect the whole person.

Dimensions of Health
• Physical Health
• Influence by genetic and lifestyle
• Emotional Health
• When people feel good about themselves
• Social Health
• Stable and satisfactory relationships
• Older adults and immigrants are at risk for poor social health
• Social support system: an informal group of people who help each other
• Spiritual Health
• Achieved through belief in a purpose greater than the self
• May or may not involve believe in religion
• Cognitive Health
• Keeping the mind active and creative and maintain curiosity
Optimal Health & Holistic Approach
• The achievement of the best health in all five dimensions of life
• Holism or a holistic approach to health care is a concept that
considers the whole person.
• The whole person has physical, emotional, social, cognitive, and
spiritual parts.
• Caring for the mind, body, and soul
• Look at the whole person – not just where the pain is
• These parts are woven together and cannot be separated.
• Physical health does not always mean wellness
Determinants of Health
Health may be influenced by factors beyond a person’s control

Income and social status

Social support networks
Education and literacy
Employment and working conditions
Social supports
Physical environments
Determinants of Health (Cont’d)
Personal health practices and coping skills
Healthy child development
Biology and genetic endowment
Health services
Gender
Culture
Illness and Disability
• Illness:
• Loss of physical and mental health
• Disability:
• Loss of physical and mental function
• No two clients will experience illness and disability in the same way.
Changes Associated with Illness and
Disability
• Change in routine
• Change in work life
• Change in family life
• Change in sexual function
• Loss of independence
• Loss of dignity
• Change in self-image
Caring for Clients With Illnesses or
Disabilities
Always remember to apply the DIPPS principles
• Dignity:
• Be aware of your facial expressions
• Independence:
• Encourage pt to participate in their care
• Preference:
• Respect pt’s choices and ask them what is important to them
• Privacy:
• Promote privacy by: knocking before entering, drawing curtains, closing doors and
windows, covering the client, keeping the info confidential.
• Allow privacy to fulfill the sexual needs
• Safety:
• Always check with your supervisor and the care plan for safety measures
Principles of Health Care Ethics
• Health care ethics is the philosophical study of what is morally right
and wrong when providing health care services
• Ethical dilemma is a situation that will often involve an apparent
conflict between opposing moral choices
Four basic principles of health care ethics:
• Autonomy: respecting pt’s right to make choices for themselves
• Justice: being fair
• Beneficence: doing good
• Nonmaleficence: doing no harm
Autonomy
• Also called self-determination
• Means having the freedom and choice to make decisions
• Person who is mentally competent, has the right to make decisions
about lifestyle, medical care and services.
• Ensure to obtain informed consent before any procedure
• It can become complicated if their decision is unsafe
• Always consult with your supervisor
• Ensure to not judge about your pt’s choices
• Do not give advise and never express your opinion or disapproval.
Justice
• All people should be treated in a fair and equal manner.
• Be concerned for all pt, regardless of their conditions
• Example: spending less time with the pt who is demanding and
ungrateful or avoid a pt whose lifestyle is different from your own.
• Do not betray the pt’s trust
• Keep the confidentiality
Beneficence
• Doing or promoting good.
• Always consider meeting the pt’s needs to be your most important
priority
• Stay within the boundaries of a professional helping relationship
• Never take advantage of a pt’s compassion and generosity. Exp: Never
ask for or accept money or loans from pt
• Do not take sides with a pt against a family member
• Self discipline is important, especially working in home care.
Nonmaleficenc
• Doing no harm, intentional (abuse) or unintentional (accidental injury
or negligence).
• To avoid it, only perform tasks that you have been trained
• Never reveal info about diagnosis or treatment plan
• Try to participate in educational programs offered by your employer
to keep your skills updated.
• You can protect your pt from harm by practicing infection control
techniques, recognizing common safety hazards, and knowing how to
prevent accidents.
Dealing with Ethical Dilemmas
• When making an ethical decision, carefully consider the four principles of
health care ethics.
• Ask yourself these questions about each option:
• Does the option respect the pt’s wishes and preferences?
• Does the option treat the pt justly and fairly?
• Does the option provide the pt with a short-term benefit or long-term benefit?
• Could the option cause harm or increase the pt’s risk for harm?
• What are all of the possible consequences to the client, family, or others with this
option?
• Always involve your supervisor in finding the solution, especially when
one option could harm the pt.
Ethical Dilemmas
• Miki works in a long-term care facility. Mr. Petrova is a resident on her
resident care unit. Miki smells alcohol on Mr. Petrova’s breath
following his son’s visit. She comments on this to Mr. Petrova and he
tells her that his son had bought him a bottle of liquor. Residents
keeping alcohol in their room is against facility rules. Mr. Petrova says
that alcohol eases his pain and asks Miki to promise not to tell anyone
about the liquor.

Let’s discuss about this dilemma based on health care ethics.

Ethical Dilemmas (Cont’d)
• P.J is a PSW for Mrs. Osillo, an older woman who has a G-tube for feeding.
As P.J’s supervisor explained to him, this tube goes directly in to Mrs.
Osillo’s stomach through an opening made in her abdomen, and all of her
foods and nutrients are given through it. She cannot have anything to drink,
as she has severe problems swallowing and any food or fluids would go into
her lungs, resulting respiratory problems and pneumonia. Mrs. Osillo has
already been admitted to the hospital for pneumonia twice this year.
• Mrs. Osillo complains that she feels thirsty all the time and begs P.J to give
her something to drink.

Let’s discuss about this dilemma based on health care ethics.

Promoting Client Psychosocial
Health
• Psychosocial health is well-being in the social, emotional, intellectual, and spiritual
dimensions of one’s life.
• There are two common theories that address a client’s psychosocial health:
• Erikson’s stage of psychosocial development
• Maslow’s hierarchy of needs
• According to Erikson, factors that influence psychosocial health include the followings:
• Personality
• Family background
• Environment
• Life circumstances
• According to Maslow, certain basic needs must be met for a person to function and he
arranged them in a order of importance.
Erikson’s 8 stages of Development
• Trust vs mistrust (age 0-1)
• Autonomy vs doubt (age 1-3)
• Initiative vs guilt (age 3-6)
• Competence vs inferiority (age 6-12)
• Identity vs role confusion (age 12-20)
• Intimacy vs isolation (age 20-40)
• Generativity vs stagnation (age 40-65)
• Integrity vs despair (age 65 on)
Maslow’s Hierarchy of Needs
Basic needs from the lowest level to the highest level, are:
• Physical needs: oxygen, food, water, shelter, etc.
• Safety and security needs: protection from harm, danger, fear, and pain
• Love and belonging needs
• Self-esteem needs: thinking well of oneself and being well thought of by
others
• The need for self-actualization: realizing one’s full potential, involves
learning, understanding, and creating.
• It is the last need in hierarchy as it can be postponed and life will continue.
People normally meet their own needs.
Legislation
• The foundation of a good client-worker relationship is a basic
understanding of the client’s rights, the worker’s rights, and legal
responsibilities.
• As a PSW, you need understand:
• Your professional code of ethics
• You employer’s policy
• Federal, provincial or territorial laws
• Ethics and legislation are different
• Ethic is what is wrong and what is right or what is good and what is bad.
• Legislation is a body of laws that govern the behavior of a country’s residents.
Basic Human Rights in Canada
• Moral rights: are not based on written laws, but they are based on moral principles.
• Legal rights: formally recognized in law and are based on rules and principles
outlined in the law and enforced by society.
• The Canadian Charter of Rights and Freedoms: is federal legislation that applies to
all Canadians.
• Freedom of religion
• Freedom of thought, belief and expression
• Freedom of form a union or engage in a strike
• Right to vote
• Right to enter, stay in, or leave Canada
• Right to life, liberty, and security
• Right to equality without discrimination based on race, color, religion, age, gender or mental or
physical disability.
Bill of Rights: some facilities and agencies write
their own bills of rights based on provincial laws.
(Box 9-2, pg 132)
Bills of Rights (Cont’d)
All clients have the following rights, which are a combination of moral
and legal rights:
• The right to be treated with dignity and respect (Box 9-4, pg 136)
• The right to privacy and confidentiality (Box 9-5, pg 137)
• The right to give or withhold informed consent
• The right to autonomy (pg 140)
The Right to Give or Withhold
Informed Consent
• Consent: whether or not the pts agree to medical treatment, health care, or personal care
services.
• For the consent to be valid, it must be informed consent.
• It is based on having received accurate and complete information that is provided by the
facility, agency, or physician.
Consent is informed when the pt clearly understands the followings:
• The reason for the treatment or service
• What will be done
• How it will be done
• Who will be doing it
• The expected outcomes
• Potential risks and side effects of the treatment
• Other treatment options
• The consequences of not having the treatment
Informed Consent
• When a client enters a facility, he or she signs a form giving general
consent to treatment.
• The PSW is never responsible for obtaining written consent or giving
medical information.
• Advance directives: are legal documents that allow clients to convey
their decisions about their own end-of-life care.
• Power of attorney or substitute decision maker for health care or
proxy: next of kin.
Legal Issues
• Criminal laws: are concerned with offences against the public and
against society.
• Crime: a violation of criminal law, eg: theft, murder, rape, or abuse.
• Civil laws: deals with relationships between people, eg: law relating
to divorce, adoption.
• Tort: is a wrongful act committed by an individual against another
person or the person’s property. It can be intentional (negligence), or
unintentional (assault, battery).
Legal Issues (Cont’d)
• Negligence: occurs when a person fails to act in a careful or competent
manner and thereby harms the client or damages property.
• The negligent individual may have to pay damages (a sum of money) to the
injured person.
The causes of negligence are:
• Not performing a task or procedure correctly. Exp: not keeping a urinary
drainage bag below the client’s bladder level.
• Performing a task that you are not qualified to do. Exp: giving meds.
Remember that refusing to follow the request that is beyond your scope of
practice is your right.
• Making a mistake because of carelessness that causes harm to a client. Exp:
if you are not mop up a spill, you could cause a client to slip and fall (Box 9-6
pg 141)
Legal Issues (Cont’d)
• Assault: Is identified in a Canada’s Criminal Code and can be defined as
intentionally attempting or threatening to touch a client’s body without the
client’s consent, causing the client to fear bodily harm.
• Exp: threatening an uncooperative client to tie down.
• Battery: is the actual intentional touching of a client’s body without the
consent.
• Exp: force-feeding a client
• Therefore, always explain the procedure and what you are going to do and
make sure the client agrees to it.
• Consent may be verbal (yes or OK) or physical (a gesture such as a nod or
getting ready for the procedure)
Legal Issues (Cont’d)
• False Imprisonment: unlawful restraint or restrictions on a person’s
freedom of movement.
• Invasion of Privacy: every client has the right not to have her name, photo,
health information, or personal info made public without having given
consent. Violating this right is called invasion of privacy.
• Defamation of Character: is injuring the name and reputation of a person
by making false statements to a third person.
• Libel: is a criminal offense when it is knowingly making false statement that
harms a person’s reputation in print, writing, or through pictures or
drawings.
• Slander: making harmful false statement orally.
Your Legal Rights
• Human Rights Legislation: protect workers’ basic human rights by
stating that employers must treat all workers equally and not
discriminate on their race, colour, gender, ect.
• Workers have the right to be free from harassment in the workplace
by the employer, client, or a fellow worker.
• Harassment: means troubling, offending or worrying a person
through one’s behavior or comments.
Your Legal Rights (Cont’d)
Occupational Health and Safety Legislation (OH&S): outlines the rights
and responsibilities of workers and employers in creating and
maintaining a safe work environment.
• WHMIS (Workplace Hazardous Materials Information System): is a
national plan to provide info on the safe use and potential health risks
of hazardous materials.
Employment Standards Legislation: covers basic rules such as
minimum wage, how wage are paid, how many hrs of work per day, fair
overtime pay, vacation and holidays pay, and leave of absent.
PSW Responsibilities
Personal Care:
• Assisting with ADL (activities of daily living) – eating, bathing,
grooming, dressing, toileting, moving and positioning, walking
• Assisting with IADLs (instrumental activities of daily living)- are the
complex skills needed to successfully live independently, such as
handling finances, assisting with management of medications,
arranging transportation, shopping, preparing meals, assisting with
using a telephone or other communication devices, ect.
Note: PSW is not responsible for deciding what should or should not be
done; must observe and report changes in client’s behaviour
 PSW Responsibilities (Cont’d)
Support for Nurses and other Health Care Providers:
• Clean equipment, measure and report vital signs, assist with simple wound care,
assist with oxygen therapy, heat or cold applications, and range-of-motion (ROM)
exercises.
Family Support:
• Assisting with admissions and discharges, help families care for loved ones who
have health issues, help with child care, ect.
Social Support:
• Help client to participate in social activities, meeting with friends, organizing
games, be a client’s companions, teaching client how to cook/clean/ or shop by
themselves.
Housekeeping or Home Management
The People You Support
It depends on workplace setting:
• Patient: Person receiving care in a hospital

• Resident: a person living in residential facility, such as nursing home

• Client: a person receiving care in the community

Note: no matter what you call them, take them as a person with unique
life experience and situations, desires and opinions.
Groups of Clients
• Older Adults
• People with disabilities
• People with medical issues: such as broken bones, diabetes, cancer.
• People having surgery
• People with mental health issues
• People needing rehabilitation
• Children (pediatric unit in hospital)
• Mothers and newborn
• People requiring special care: ICU, CCU, kidney dialysis units, ER, burn units.
Health Care Team
Regulated Workers:
• Has a professional organization called a “College”, which sets education and license
requirements.
• It establishes the scope of practice, code of ethics, standards of conduct.
• Exp: Nurses (RN or RPN), Physicians, Pharmacist, etc. (Table 1-1, pg 12).
Unregulated care providers (UCPs):
• Are health care providers who perform services under the direction and supervision
of a client, family member, regulated health care provider, or employer.
• They do not have official code of ethics, but they have to follow the codes of
behavior dictated by their employers.
• Exp: PSW, recreational therapist, Social worker (in some provinces)
Teamwork
• May be a nurse and support worker only
• Long term care teams often include a physician, nurses, support
workers, therapists, the client, and the client’s family
• Family conference –
• a meeting attended by the health care team and family members to discuss
the client’s care
• a time to ask questions, express feelings, make decisions
Types of Settings (Chapter 3)
• Acute care (hospital)
• Long-term Care (Subacute)
• Community (home care)
• Day Programs
• Mental Health Homes
• Group Homes
• Retirement Homes (Assisted-living facility)
• Respite Services (provide temporary break to family caregivers)
Being a Professional
• Is an approach to work that demonstrates respect for others,
commitment, competence, and appropriate behavior.

• Being cheerful and friendly, keeping work schedules, performing tasks

completely, being helpful to the team.
Being a Professional (Cont’d)
To be a true professional, you must demonstrate the followings:
• Positive attitude: speak in a professional manner, avoid the use of
slang terms, think before you speak, do not gossip, do not complain.
(Box 1-1, pg 14)

• Sense of responsibility: admit your errors, accept constructive

feedbacks, learn from others, inform your supervisor if you will be
late or unable to work, don’t take shortcuts.
Being a Professional (Cont’d)
• Professional appearance: includes grooming, cloths,
and hygiene. (Box 1-2, pg 15)
• Discretion about client information: showing good
judgment about what you say, how you say it, when
you say it, and where you say it. Never talk with a
client about another client.
• Lifelong learning: equipment and techniques can
become outdated, ensure to always update your
knowledge.
Being a Professional (Cont’d)
• Advocating for the client: Always share your observations with the
health care team, especially when your client is unable to speak
themselves. Report unprofessional behavior of co-workers to your
supervisor?!!!!
• Discretion about personal matters: keeping personal problems out of
the workplace.
• Using acceptable speech and language: never fight or argue with
clients, family embers, or co-workers. Be careful of using your words.
Working with Others (Chapter 6)
• Assigning: appointing someone to take responsibility of providing
client care that is within that person’s scope of practice or scope of
employment.
• Task: is a function, procedure, or activity that a person assists the
client with or performs for the client.
• Delegation (transfer of function): is a process by which a nurse
authorizes another health care provider to perform certain tasks.
Five Rights of Delegation (Box 6-4,
pg 96)
• The RN or supervisor must review the:
• Right task
• Right circumstances
• Right person
• Right directions and communication
• Right supervision and evaluation
• Do not be offended or angry if your are not allowed to perform a task
that you usually do
Accepting vs Refusing a Task
Accepting a task:
• When you agree to perform, you must complete the task safely.
• Do not hesitate to ask for help if you are unsure or have questions
• Always report what you did and your observations
Refusing a task:
• You have the right to say no.
• You need to have a good reason for not doing a task
• Use the five rights of delegation as a guide
• You must never ignore an order or request to do something
• You must not refuse a delegated task only because you do not like or want to do
them. You may lose your job!
[Link]
Stress (Chapter 7)
• Stress is a normal part of life
• Stress is the emotional, behavioral, or physical response to an event or situation
• The event or situation that causes stress is called a stressor
• New situations or illness can cause stress
• Some stress can be good; called eustress (it can make you work more effectively
to accomplish tasks)
• Acute stress: short in duration
• Chronic stress: is ongoing and last longer
• Burnout: a state of physical, emotional, and mental exhaustion. Chronic stress
can lead to burnout.
Common Stressors by Older Adults
• Loss of spouse, friends, family members, kids or grandchildren.
• Health problems
• Economic worries, since a large number of older adults are on a
limited, fixed income
• Increased dependency on other person to help
• Loneliness and isolation
• Decline in abilities because of the normal aging process
Managing Stress
• Don’t ignore signs of stress – this can result in illness and burnout.
Strategies:
• Develop self-awareness: (Source of stress and how to eliminate, avoid, or
cope with them)
• Take care of your needs: have healthy mind and body, exercise, enough sleep,
good diet, balance family/work/relaxation, have time for fun.
• Think positively: keep the sense of humor, look at the big picture.
• Be assertive: make decisions that work for you. Do not say yes to things when
you really want to say no. Never agree to do more than your limits.
• Ask others for help
• Learn to accept things you cannot change
 Managing Stress (Cont’d)
Practice calming exercises:
• Close your eyes, take deep, slow breaths. Relax your
stomach muscles. Breath in through your nose and out
through your mouth. Your stomach should rise about
3cm as you breath in, As you inhale, count slowly up to
4. As you exhale, count slowly back down to 1. Pause
between breaths.
• Relax your muscles, from your face down to your feet.
• If possible, take a few minutes and remove yourself
from the stressful situation.
 Defense Mechanisms in Time of
Stress
• Are used to delay or avoid uncomfortable feelings such as anxiety, guilt,
stress, or embarrassment.
• Relieving stress by helping the person to avoid facing a troubling reality.
• Exp: A client is upset that her daughter is not able to visit her
frequently. She blames the city bus system!!!
• Understanding defense mechanisms gives you insight into what your
clients may really be feeling.
• Help your clients by validating their feelings.
• Validation means to acknowledge, recognize, or confirm the client’s
feeling.
• As a PSW, your role is to observe and report the signs and symptoms of
stress, not to diagnose.
 Time Management
• To manage your time, you must identify your priorities.
• You may identify a large number of priorities, decide which ones are the
most important.
• Assign a number to each, with 1 being the most important and 10 being the
least.
• Now you are ready to turn your priorities into goals.
• Time management strategies for PSW:
• Determine priorities
• Be organized
• Ask for help
• Get adequate rest
 Tips to Save Time and Stay
Organized
• Follow the assignment sheet or the care plan
• Remember the client’s needs and priorities
• Know what tasks need to be done at a certain time
• Set yourself time limits; work within those limits unless a client’s needs are
more pressing
• Develop routines that work for you and your client
• Start with the tasks that must get done
• Learn to say no firmly, and positively
• Make sure that you have the necessary equipment and supplies before you
start a task and put them back in their proper place after completing the task.
Setting Smart Goals
• Your goals should be SMART
• S Specific Goals: be clear Exp: losing weight (not specific)
• M Measurable: tell you if you are making progress
• A Achievable: how much time and effort you put into them
• R Realistic: consider time, available resources, and skills
• T Timely: time should be considered to motivate you.
Decision Making in Different Health
Care Settings
Problem Solving:

• Identify the problem

• Analyze the problem
• Find a solution
• Devise a plan
 Managing Conflict
• Approach the person and ask to talk privately
• Be polite and professional
• Agree on a time and place to talk
• Talk in a private setting, where nobody can see or hear you
• Explain the problem and what is bothering you. Focus on the problem, not on the person.
• Listen to the person’s response and do not interrupt
• Identify ways to resolve the problem. Offer your own thoughts, and ask the other
person’s ideas
• Schedule a date and a time to review the situation
• Thank the person for meeting
• Implement the solutions
• Review the situation; allow 10 days for a response
• If you are unable to resolve it, ask your supervisor for advice
 Interpersonal Communication
(Chapter 5)
• Interpersonal Communication: is the exchange of
information between two people, usually face to
face.

• Sender: person who sends the message

• Receiver: the people who receive and interpret the

message

• Feedback: information provided by receiver in

response to the message.
Factors Influence the
Communication
Perceptions:
• How a person views events and understand messages
• Based on individual’s cultures, education, and personal background
Experience and confidence:
• Communicate in an assertive and professional manner to avoid the clients to
be resistant to the care or follow your instructions
Physical and mental health:
• It can affect both sides, PSW and your clients
Age:
• Different terms and expressions, which are sometimes hard to understand or
misinterpreted.
Factors Influence the
Communication (Cont’d)
Mood and emotions:
• As a PSW, try to keep your emotions under control
• Be prepared for changes in your client’s emotions. Report and record your observations.
Values:
• Respect your client’s methods of communication without making any reference to the difference
in values.
Beliefs and cultural influences
Gender:
• Males address the issues directly and use less verbal communication
• Females disclose more personal info, use more active listening, and encourage conversations.
• Electronic communication and social media:
• Do not require to use body language
• Use “cyber-speak”, abbreviations which can cause misunderstanding
Workplace Etiquette
• People need to behave in a professional, ethical, friendly, and
respectful manner to all staff and co-workers at all the time.
• Do not speak the language other than English in the workplace
• Exp for breach of workplace etiquette:
• Gossiping about clients or other team members
• Avoiding eye contact
• Making non supportive facial expressions, such as eye-rolling
• Texting on a cellphone while sitting with co-workers at breaks
• Bullying
 Verbal Communication
• Choose your words carefully
• Be aware that emotions can affect your communication
• Use simple, everyday language: no medical terminology
• Speak clearly, slowly, and distinctly
• Use visual clues: for clients who cannot hear but can read
• Control the volume and tone of your voice: Do not shout, whisper, or mumble
• Present info in a logical manner: organize your thoughts and present them in
sequence
• Ask one question at a time
• Determine understanding: ask the client to repeat the message in her own words
• Do not pretend to understand: ask him/her to restate the message
 Nonverbal Communication
• Body language: posture, appearance, facial expression and eye contact.
• Mixed messages: saying one thing with words but another with body language.
• Touch: can convey warmth, comfort, concern, and trust.
• Always ask permission each time. It can be uncomfortable for people who
experience torture or child abuse.
• Silence: can convey messages of acceptance, rejection, fear, or need for
quiet and time to think.
• During sad time, you do not need to say anything; just being there shows that you
care
• Can give you or other time to organize thoughts and choose words
Communication Techniques
(Therapeutic Communication)
• Listening means being attentive to the client’s verbal and nonverbal
communication
• Use the senses of sight, hearing, touch and smell
• Active listening means paying close attention to what the client is
saying and their nonverbal communication
 Guidelines for Active Listening
• Face the client.
• Make eye contact: also consider cultural
preferences
• Lean toward the client: do not sit back with
your arms crossed
• Respond to your client
• Avoid communication barriers: such as
interrupting or giving advice
Communication Techniques (Cont’d)
• Paraphrasing: is restating another person’s message in one’s own
words.
• Empathetic listening: being attentive to the speaker’s feelings.
Involves acknowledging the other person’s pint of view without
judging.
• Avoid quick and thoughtless responses such as:
• “I know how you feel”
• “I feel sorry for you”
• “I would not want to be in your shoes”
Communication Techniques (Cont’d)
• Asking closed questions: focus on specific info and usually requires
“yes” or “no” answer or brief response.
• Asking open-ended questions: invite a person to share thoughts and
feelings.
• Clarifying: restate the message as a question or ask to repeat.
• Focusing: limiting the conversation to a certain topic.
 Assertiveness
• Is a style of communication in which thoughts and feelings are expressed
positively and directly without offending others.
• An assertive person stands up for her rights while respecting the rights of
others.
• It is different from being aggressive and from being passive.
Exp:
• Kara just graduated as a PSW. Her first job is at a long-term care facility,
where she was hired to replace Debbie. Mr. Beruti is a 28 yr old client, who
has had both his arms amputated. While Kara is shaving him, he shouts, “Be
careful! You almost hurt me. You obviously don’t know what you are doing.
The nurse told me this is your first job. You are not as good as Debbie. If you
do not get better at this, I will report you.”
Communicating with Angry Patient
• [Link]
Communicating with Clients Who
Have Dementia
• [Link]

• Box 5-4, pg 82
Medical Terminology (Chapter 13)
• Word elements: medical terms are made up of parts or word elements.
• Important word elements are prefixes, roots, and suffixes.
• Prefixes: is placed at the beginning of a word that changes the meaning of
the word. They are never used alone.
• Exp: Oliguria: small amount of urine
Olig (small amount) is placed before uria (urine)
• Roots: contains the basic meaning of the word
• Exp: psych ----- mind phleb------ vein hepat------liver
• Suffixes: is placed at the end a root to change the meaning of the word. They
are never used alone.
• Exp: -stomy, -ostomy: creation of an opening
Direction Terms
• Anterior (ventral): located at or toward the
front of the body or body part.
• Distal: the part farthest from the center or
from the point of attachment.
• Lateral: the farthest away from the midline of
the body
• Medial: the closest to the midline of the body
• Posterior (dorsal): the back surface of the
body
• Proximal: nearest to the trunk of the body or
the point of origin
 Abdominal Regions

• RUQ: Right Upper Quadrant

• LUQ: Left Upper Quadrant

• RLQ: Right Lower Quadrant

• LLQ: Left Lower Quadrant

Abbreviations
• Are shortened forms of words of phrases that help save time and
space in written communication.
• Each employer has a list of accepted abbreviations, which you obtain
when you are hired.
Exp:
• Abd: abdomen
• BM: bowel movement
• BP: blood pressure
• NPO: nothing by mouth