English For Nursing

UNIT 1: THE HUMAN BODY
Extract from Anatomy course lecture

Welcome to today's lecture. Last week we looked at the respiratory system and how
the lungs separate oxygen from other gasses which we breathe. Today, we will be looking at co-
dependence within three of the body's most important systems: the central nervous system (CNS),
the cardiovascular system and the digestive system.
The nervous system can be divided into two parts: the central nervous system and the peripheral
nervous system. The central nervous system is comprised of the brain and the spinal cord, and is
responsible for processing the information which is sent to or received from the peripheral
nervous system which is made up of the body's nerves. The brain processes information while the
spinal cord acts as a delivery system for the information and impulses.
Information transmitted through the central nervous system tells our bodies how to react in a
certain situation, such as when we want to take a step the brain tells our knee joint to bend, or
when we touch something hot we receive information giving us a burning sensation. The CNS
also sends information about infection so that the appropriate organ e.g. the spleen can fight
certain types of bacteria. It is a common misconception that the brain is the largest organ in the
human body, when in fact it comes in at third largest after the skin and the liver respectively.
The central nervous system also controls our second system of the day, the cardiovascular system
(also known as the circulatory system) which delivers blood and oxygen to the various parts of
the body. The relationship between these two systems is quite complicated as each has an effect
on the other. If we take the heart for example which is a key organ in the cardiovascular system,
we can think that it feeds the brain and as such the CNS with oxygen and blood, but at the same
time it is the brain that controls the heart telling it how often to beat.
In fact the cardiovascular system is not only responsible for delivering blood and oxygen, but also
for transporting nutrients, hormones and waste throughout the body. All of these are carried in the
blood, of which an average adult has about 5 liters. The heart acts as a pump which circulates the
blood through the capillaries, arteries and veins. It is interesting to note that if these were laid
end-to-end, the estimated length would be 100,000 KM.
Our next system, the digestive system is closely linked to the cardiovascular system as on the one
hand it requires about 30% of all cardiac output. And on the other, the digestive system separates
nutrients from food before they can be distributed via the cardiovascular system. Thus, as with
the relationship between the CNS and the cardiovascular system, each system needs the other to
work.
When thinking about the digestive system, the first organ that comes to mind is usually the
stomach but surprisingly, this is not the largest organ in this system. That is, in fact the liver
which is actually the largest solid organ in the body. The liver performs several functions among
Dang Van Binh Trang 1

which are cleaning the blood, producing digestive liquids (bile) and storing energy. Again, we can
see examples of cross system relationships here.
As well as the liver and stomach, the digestive system is made up of the pancreas and
the intestine. The pancreas, like the liver, aids in digestion of food. After food has passed
through the stomach and has been 'ground' into tiny pieces, it enters the intestine where the bile is
added and the nutrients are extracted from the food. Waste products then move further down the
intestine. Now, don't forget to join me next week when we will examine the tonsils and
other glands.
 Discuss the questions:
Can we say that one organ system is more or less important? Why?
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What other relationships can you think of between the systems of the body?
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Which system would you like to specialize in? Why?
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 Speaking practices:
The program is designed for people with respiratory system troubles, such as asthma.
Lung cancer is particularly common among smokers.
Epilepsy is a potentially fatal disorder of the central nervous system.
Research has shown that a glass of red wine a day can help your cardiovascular system.
You have to be very careful if you hit your head in case of brain damage.

UNIT 2: MEDICAL EQUIPMENT
When hearing the term 'medical equipment', a typical layman, whose only knowledge about health care
comes from an annual check-up at a local surgery and TV shows such as 'House, M.D.' or 'ER', might
think of complex devices like a defibrillator, the star of the show in every scene in which somebody's
life is saved.
However, medical equipment might refer to both very complex devices used by professionals as well as
to simple instruments which you might even use yourself. Let's see what equipment is used when you
catch influenza.
Imagine you wake up in the morning with a terrible headache, feeling feverish. You quickly phone the
boss and say you need a day off, then grab a thermometer to take the temperature. Gosh, it's 102
degrees Fahrenheit! You really need to go to the doctor's. After you arrive at your local clinic and wait
some time in a queue, the GP asks you in. She asks what is wrong and then puts a tongue depressor in
your mouth to see your throat. Then she asks you to take off your sweater and uses a stethoscope to
listen to your chest. Finally she tells you that you have caught the flu, prescribes you some medicine and
says you must stay at home for a couple of days.
As you can see, several pieces of equipment are used even in such a common procedure like diagnosing
flu, some of which you may even have at home. What about other examples? Let's see what equipment
might be used in case of a broken bone.
It's mid February and you are skiing in the Rockies. You are having an amazing time but you fall and
feel terrible pain in both your shin and your arm. You have probably broken your arm and your leg!
It's so painful you can't move so you call out mountain rescue. They come by chopper, put you on
a stretcher, use a splint to immobilize your limbs and take you to the hospital. You are told you have
broken your leg and it's put in a cast. If you're lucky and your arm is not broken, it's only wrapped
in bandage and you have to wear a sling. As a result, walking on crutches is out of the question, so you
leave the hospital in a wheelchair. But how do the doctors make sure your limb is broken or not? Well,
you have an X-ray taken.
What other gear is used in hospitals? Let's study a case of a person brought to an A&E department with a
head injury. The person is brought by paramedics, who have already put a brace on his or her neck in
order to prevent further injury. Firstly, diagnostic equipment is put to use in order to check the person's
condition.
An MRI scan is taken to check for bleeding and swelling in the brain. If immediate surgery is required,
the patient is administered an anesthetic by means of a syringe. Then a surgeon uses a scalpel to cut into
his or her body and forceps to manipulate the tissues. After the surgery is performed, a catheter is
inserted for the time when he or she is immobilized.

Various types of medical equipment, ranging from basic tools to highly advanced cutting edge devices,
are used in very different situations. One thing is certain - each piece has been developed to help us
recover or even save our lives. And we might need them at the very beginning of our lives - as is the case
with an incubator, which is used in neonatal units to help or treat prematurely born children.
Which three pieces of medical equipment do you think every hospital should have?
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What equipment do you use on a regular basis?
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What was the most revolutionary piece of medical equipment of the twentieth century? Why do
you think so?
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I need to wrap the bandage around my ankle, as I suspect I have sprained it.
If the patient has suffered a severe head injury and there is a risk for a spinal cord injury, he
or she will have to wear a neck brace.
A broken bone will be treated with the cast unless it is very small.
As you will be immobilized after the surgery so unable to go to the toilet, you will have a
catheter inserted.
She’s been walking on crutches for 4 weeks now and is really looking forward to the moment
when her leg has fully recovered.

UNIT 3: IN THE HOSPITAL
A dialogue between the mayor and the hospital director
A: Mr Hecky, welcome to Blackwell Community Hospital. I am honored you decided to attend our
modest opening ceremony. Before we begin the tour of the facility, I would like to thank you for
your personal involvement and endeavors, which greatly contributed to the construction of the most
modern medical center in the region. We are also very grateful for...
B: Sorry to butt in, doctor, but I have a very busy schedule today and only came to see what so
much public money was spent on.
A: Ahem. I totally understand that, taking into account the fact that you yourself might end up being
an inpatient some day.
B: Get on with it, doctor. This is the east wing, right? What's that place over there, near the
entrance, with A&E sign flashing above? We only treat American and English citizens or what?
A: That's not quite right. A&E stands for Accidents & Emergency, which is a department where
patients come without prior notice.
B: So are they treated there and then go home?
A: Well, those who are not severely injured and whose life is not in danger, are asked to consult a
specialist at one of our clinics for a detailed diagnosis. Can you see a large sign saying 'Neurology'
on your right? Patients are sent there if it is suspected their condition is related to problems with
their nervous system. Opposite is a sign which says 'Cardiology', where patients suffering from
heart disorders are sent. At a clinic, patients may be given some medicine, which a doctor picks up
from the pharmacy at the end of the hall. We also have many patients who do not stay in the
hospital, but only come in for treatment. In such a case, we call them outpatients.
B: What about people after accidents or with serious conditions, you know, when an ambulance
brings them?
A: Well, they are taken upstairs, where we will go now. This is where patients with severe injuries
or diseases are transported. On your left you can see operating rooms, where surgeries are
performed.
B: Surgery? I heard that can be very painful.
A: As long as anesthetics are administered, a patient does not feel a thing.
B: Right. What about that room on right, with all that fancy equipment?
A: This is the Intensive Care Unit (ICU), where patients with the most severe and life-threatening
injuries are provided care. Frequently, people who were involved in a traffic accident are taken
there.
B: How long do patients stay there?

A: It may be a few days or a couple of weeks, it depends on the severity of injuries. When their
condition improves, they are transported to a ward, where they remain until discharged.
B: Which means they are healthy and can go home?
A: Well, they can go home, but may need further treatment. Very often physiotherapy is necessary,
particularly in case of victims of accidents, to recover fully.
B: I understand. What about the west wing?
A: Let's go there. Originally that part of the building was a university hospital. Twenty years ago it
was adapted to serve as a psychiatric ward. Now its first floor addresses needs of female patients.
There is a gynecology clinic, a maternity ward and a neonatal unit, where newborn babies are
provided treatment if necessary.
B: What about the second floor?
A: The oncology ward is located there, where cancer patients are treated. As they often suffer from
agonizing pain, we located the palliative care there, which ...
B: I have to go, doctor. But I have one final question to you - if in the future I need some advice,
where do I go?
A: I am very sorry, Mr Hecky, but the funds that were available to us were not sufficient to build
the geriatrics ward. I am afraid it will have to be Stanton General, only 30 miles from here.
What are the typical departments usually found in each hospital?
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Would you say that one department is more important than others? If so, which one and why?
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Which department would you like to work in? Why?
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She was taken to A&E on suspicion of appendicitis.
Before we begin, you will be administered a local anesthetic.
If you suffer from chest pains or find it difficult to breathe at times, please consult a
cardiology specialist.
Please confirm your appointment by phone two days before coming to the clinic.
Geriatrics’ main goal is to promote health in old age by preventing and treating diseases.
UNIT 4: DIAGNOSIS PART 1,2

Part 1:
For many years medicine has been seen as a profession far removed from glamour and popular culture,
but in recent years the TV show Dr House has popularized the world of diagnostic medicine.
Week after week, he unfailingly manages to diagnose even the most unusual of diseases and even has
time for some fun and games. However, life in the real world is slightly different.
Diagnostic medicine is predominantly the realm of general practitioners, or family doctors who are
usually the first contact between the patient and the medical professionals who are there to cure them.
The priority for a GP is to diagnose the patient as quickly and accurately as possible, and to do this they
will need to examine the patient and study the symptoms which the patient has. If a patient is presenting
with a rash, then there is a good chance the doctor is looking at nothing more serious than an allergic
reaction.
Correctly diagnosing a patient is no easy matter, and takes a great deal of hard work - something which
Dr House fails to show. There are thousands of possible medical conditions, many of which show some
of the same common symptoms such as vomiting or nausea, so in diagnosing a patient a doctor must
look at the big picture of all symptoms together rather than individually.
In doing this most diagnostic examinations will take the symptoms you have, the symptoms you had as
well as your physical and mental state into account. So the fact that the patient has worked a 60-hour
working week and is feeling fatigued can be just as important to ascertaining the problem as the fact he
has a poor diet and has had constipation for the last three days.
It takes years of study and many more years of practice to be able to work effectively in diagnostic
medicine as to the untrained, and even trained eye two very different symptoms can present in a
surprisingly similar way. If we take the example of a bruise and a lesion, the causes and meanings of
which can be completely different but may appear to be almost identical, and it is only through practice
and knowing what you are looking for that you can see the difference.

Most of the time, the diagnosis will show a common illness for which the doctor
will prescribesomething to help like: painkillers to stop an ache or barbiturates to relieve insomnia but
some visits may result in nothing more that some good advice like: go to bed and rest if the patient is
suffering from the common cold.
Of course with so many viruses, bacteria, conditions and disorders it is impossible for one doctor to be
able to diagnose everyone so if your GP is in doubt he will refer you to a specialist who will be able
to carry out tests to find the cause of that tingling sensation in your foot.
Unfortunately, more and more people are turning to the internet to help with their diagnosis rather than
visiting their family doctor. Admittedly, it may save time and money - but a computer is unable to
analyze the symptoms and compare them to you medical history, so by simply stating that you
are running a fever - you could be told there is nothing wrong, or you could be told you are dying.
So even though the real doctors may be less entertaining than Dr House, if you feel that something is
wrong, you are much better off going to you local clinic than jumping online.
Why do you think medical TV shows like Dr House are so popular?
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What difficulties do you think general practitioners face in diagnosing patients?
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Have you ever received a diagnosis you didn't agree with? What happened?
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Part 2:
Making a correct diagnosis is a very responsible task any time a patient consults a physician, regardless
of the supposed seriousness of the symptoms. Forming the right one will allow the patient to recover
quickly or might even save his or her life, whereas making a mistake might lead to dramatic
consequences.

Centuries ago, when physicians had very primitive tools at their disposal or had none at all, taking a
patient's medical history was sometimes the only way to identify diseases patients were suffering from.
These days, however, there are many modern diagnostic techniques that utilize cutting-edge devices and
tools, which help in diagnosis and keeping people healthy. Let's take a closer look at some of them.
The choice of a diagnostic technique depends on the symptoms a patient experiences. For example, if a
female patient comes to consult a GP, concerned about a lump on her breast she discovered when she
was performing self-examination, the GP will suggest doing a mammogram, which will allow a
specialist to determine what the lump is exactly and if any further tests need to be done. If the
mammogram indicates the presence of a tumor, then a biopsy is needed to determine whether the tumor
is malignant or not.
Biopsy is not the only technique employed in case of a suspicion of cancer. The use of a particular
method or device is determined by the patient's symptoms, results of the tests and the location of the
tumor. For instance, if there is a suspicion of a colon cancer, an endoscopy is performed, which involves
inserting a tool directly into the organ (in this case the colon). In the case of women, a
common screening method used in order to detect cancerous or pre-cancerous changes in the female
reproductive system is called a Pap test, named after a Greek Doctor Georgios Papanikolaou, who
invented it.
Some techniques are less invasive and do not require putting anything into the body or removing
anything from it. For example, if doctors suspect a brain tumor, they will recommend tomography,
performance of which will result in a detailed scan of the brain. Tomography belongs to a group of non-
invasive techniques which use X-rays to produce images, called radiography, which also includes
taking an X-ray in the case of a bone fracture. Although images produced through radiography are
commonly referred to as 'X-rays', some professionals argue that they should be called 'radiographs', as 'x-
rays' are just photons of energy and cannot be seen by the naked eye.
There are more non-invasive techniques used in case of various medical conditions.
The electrocardiogram (ECG) is one of them. It is a test, which records the electrical activity of the
heart, used to detect and study such heart problems as a heart attack or arrhythmia. Another one is
a blood culture, performed to test for and find an infection in the blood caused by bacteria or fungi.
Such tests are invaluable tools , as they make it possible to verify and confirm the doctor's diagnosis and
thus assure the patient that the treatment is appropriate before the patient gives their consent for further
treatment.
The vast majority of the aforementioned diagnostic methods are adopted in case of a suspicion of a
disease or disorder. Nevertheless, there are methods employed in less depressing, more optimistic
circumstances, such as the use of ultrasound during pregnancy, to produce images of an unborn baby
still in its mother's womb.
Besides self-examination, all of the methods described in the article require a visit to a specialist clinic
or a hospital unit and are sometimes an unpleasant or painful experience. Therefore, we should not forget
to go for regular check-ups at local surgeries so as not to lead to a situation when they will be necessary.

UNIT 5: DISEASES AND ILLNESS
Extract from a medical journal.
According to recent statistics from the American Center for Disease Control (CDC), the number of
people suffering from serious diseases has increased when compared to ten years ago. This raises the
questions:
Why has this happened?
and
What can be done to stop it?
The expectation was that this number would decrease thanks to advances in medical science which have
helped in the fight against illnesses.
Anemia, for example, is now a treatable disorder but this alone is not enough to get rid of the larger
problem of heart disease which now affects over 26.5 million people in America and is largely caused
by poor diet.
On the other hand modern medicine has proved very effective in combating meningitis, with new
treatments offered for both viral and bacterial versions of the disease. Polio, which was one of the
major concerns of the last century, is close to being eradicated with only a few outbreaks in certain parts
of the developing world.
There are of course many diseases which remain incurable such as acquired immunodeficiency
syndrome (AIDS), which although is far from the levels of near epidemic of the 1980's remains a major
concern for world healthcare. Modern medicine has developed a way to treat for AIDS but has yet
to find a cure. Another incurable illness is influenza (flu), which although affecting over 10% of the
population of the western world is only treatable proactively in the form of a vaccination. So while
medical advances have made it possible to treat, cure or even eradicate illness there are still
many conditions which remain dangerous.
When thinking about why the number of people suffering from serious diseases is so high, you have to
look both at the current state of medical knowledge and also trends in patients' lifestyles. The number of
reported sexually transmitted diseases (STD's) has increased steadily over the past 50 years partly as a
result of acceptance of the diseases and partly as the young generation tends to take more risks than their
parents did.
Chlamydia is a good example of this, figures released by the World Health Organization (WHO)
indicate that there was a 7% rise in the number of cases of Chlamydia in the US in 2012 when compared
to the previous year. The increase was highest among teens, who may not even realize that they have
an infectious disease or are too embarrassed to report it straightaway which may in-turn lead
to infertility.

The answer to the question "What can be done to stop the trend of increasing levels of disease?" may be
as simple as education. If people knew the risks associated with their current lifestyle, they may be
encouraged to make some change which would spare them future illness. A great example of this can be
seen in the European approach to reducing lung cancer rates by running public information adverts on
the dangers of smoking. Or on a smaller scale, in programs to educate children on the causes
of diabetes and how to avoid contracting it.
While it may not be possible for medicine to fight against every disease, the number of terminal diseases
is decreasing and if this is combined with education on how to lead a healthier life - the future looks
good.
Why do you think certain diseases remain incurable?
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How much impact does a person's lifestyle have on their health?
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Which diseases / illnesses can be prevented? How?
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UNIT 6: ANOTOMY
Excerpt from a lecture:
Hello and welcome to today’s anatomy lecture. Whereas in the previous lesson of our course we focused
on the central nervous system, the cardiovascular system and the digestive system, their co-dependence
and the major organs that perform important bodily functions, today we will discuss the skeletal
system and the muscular system.
The skeletal system is a system of bones, which serve many vital roles, such as support, movement and
calcium storage. An adult human being’s skeleton, which is the everyday term for the skeletal system,

consists of 206 bones. Interestingly, infants are born with many more bones, between 300 and 350,
which merge as the body develops.
Let’s now look at the main bones and the roles they play. At the top of our body, in the head, there is
cranium, which is the bone structure protecting the brain. Below it there’s the mandible, which is the
bone of the lower jaw. It moves vertically when we eat or speak.
There are many important bones in our upper body below the head, of which the most significant one is
the backbone, as it supports the whole body. It consists of 24 vertebrae, which are small bone
segments. These are very sensitive and any damage to them may result in a serious disorder, disability or
even death.
Other crucial bones of the upper body are the structures which are related to our upper limbs. At the top
there are the clavicle and the scapula, the bones that our shoulders contain. Extending down from the
shoulder is the humerus, the bone in the upper part of our arm, followed by two bones forming a
forearm: the radius and the ulna.
In the middle of the upper body there is the rib cage, which is an enclosure protecting crucial organs
such as the heart and lungs. Below the rib cage and the abdomen is the pelvis – two large circular bones
to which bones of the legs are connected.
As has just been said, the bones of the legs extend down from the pelvis. The bone of the thigh is called
the femur. Below the femur and knee joint there are two bones running down to the foot. One is called
the tibia, a wider bone located at the inner side of the lower leg, and the other the fibula, which is the
narrower outer bone.
Although one of the functions of the skeletal system is movement, humans would not be able to move
were it not for the muscles, which are connected to the bones by tendons. Most experts claim that the
human body is comprised of around 639 muscles. We’ll now look at the main constituents of the
muscular system in the same manner as we did with the skeletal system, that is, from the top of the body
down.
At the upper and back parts of the neck, shoulders and back, there is the trapezius, which we use in
order to raise, rotate or draw back shoulders and move our heads. If we want to raise our arms, we use
deltoids, and when we bend our forearms, we use biceps.
When we want to get up and move from a lying to upright position, we use the abdominals, which are
the muscles located around the stomach. Then, when we stand up and move around, we use the glutes,
the muscles of the buttocks, and the quadriceps, which are large muscles located in front of the thighs.
Finally, when we want to stand on the toes, we use the calf muscles, namely the gastrocnemius and
the soleus, the former being larger than the latter.
We have just gone over the major constituents of both the skeletal system and the muscular system. I
hope you enjoyed the lecture and will find the included information valuable.

What are the main functions of the skeletal and muscular system?
How many bones and how many muscles are there in the human body?
Name 5 main bones and 5 main muscles and describe their functions.
UNIT 7: SURGERY
Surgery is a branch of medicine concerned with treating diseases and injuries by means of operative
intervention, which means a surgeon operates on a patient in order to treat an injury, improve the
functions of the body or the patient's appearance.
The word 'surgery' originally comes from Greek, in which language it means 'hand work'. This is actually
a very adequate name, as a lot of procedures are performed in an operating room manually, with the use
of modern tools and medical devices.
Let's have a look at some of the common types of surgeries, circumstances when surgeries are necessary,
the professionals involved in them and the equipment used. When there has been a traffic accident and an
injured person is brought to the hospital's A&E department, emergency surgery might be required, i.e.
one which has not been planned and arranged by the hospital's staff. The patient is usually rushed into
the operating room where doctors perform the surgery.
Before doctors begin the operation, they have to scrub up and make sure that the tools & equipment
used are sterile. If necessary, drains are placed to remove blood from wounds. After the surgery has
finished, a suture is applied to hold tissues and skin together and the patient is taken to the recovery
room where his or her health is monitored.
Most kinds surgery are known as reconstructive surgery, because by means of an operation, surgeons
attempt to restore the anatomy, function or appearance of the body. For instance, the aim of the work of
an orthopedic surgeon is to restore the functions of injured bones or muscles, whereas of a vascular
surgeon is to treat the conditions of arteries and veins. Neurosurgery, on the other hand, involves those
surgical procedures that are carried out in order to treat the disorders affecting constituents of a human
nervous system, for example the brain, spinal cord or nerves.
The saying 'fine feathers make fine birds' is taking on significance nowadays and the way we look is at
least as important as what we say or do, so cosmetic surgery is becoming more and more popular. People
decide to undergo this type of surgery if they want the appearance of a particular body part, e.g. the nose,
ear or breast, to be improved. This type of surgery is always planned, so there is some prepping to be
done before, for example arranging time off work for the operation and recovery. In most cases local
anesthesia is used before the operation. An anesthesiologist will administer a drug to suppress the
feeling of pain. As the drug is normally liquid, this may be done using a syringe. Firstly the physician
disinfects the patients' skin with an alcohol swab, then aspirates the necessary amount of the liquid and
injects it into the body part which the surgeon will operate on. If the surgery is effective, it will not only
make the patient look better, but also might boost their self-esteem and allow them to lead a happier life.

So far we have classified surgery types according to the function. However, they can also be classified
on the basis of the way an operation is carried out. Keyhole surgery, for example, which is also called
laparoscopic surgery, is a modern technique in which operations are performed through small incisions.
To magnify the surgical elements and provide aid during the operation, images from inside the body are
displayed on monitor screens. On the other hand, its opposite - laparotomy - involves making a large
incision through the abdominal wall.
Because of dynamic technological development, surgery - perceived as a branch of medicine - is
constantly developing. Surgeons use more and more advanced equipment and what was once thought to
be impossible, nowadays can be done. To stay up to date, browse professional journals,
read explanatory articles and watch documentaries, both on TV and online.
Can you explain the function of one chosen surgery type which is described in the article?
Would you agree or disagree that "Cosmetic surgery serves only the needs of the vain"?
Why?
Have you heard of any modern and groundbreaking surgical technique or equipment?
What can you say about it?
UNIT 8: MENTAL HEALTH

One of the greatest challenges faced by mental health workers, in recent years, has been breaking down
the stigma attached to mental illness. A stigma which didn't only affect the general public, but also
patients and other healthcare professionals.
A patient's reluctance to admit to suffering from a mental illness, a mere 50 years ago, is hardly
surprising when you consider the treatments that were available at that time such as electroconvulsive
therapy in which the patient was strapped down and electrocuted - very much akin to a less deadly
version of the electric chair. Going back slightly further to the 1940's and 50's, and the treatments got
even more barbaric, the frontal lobotomy involved destroying the part of the brain which was thought to
be responsible for the illness in question. These were commonly performed on patients suffering
from schizophrenia, and while the delusions were often cured, the patient was left without full brain
function. The lucky ones were just sent to an asylum to live, like a prisoner, out of sight and out of mind.
Fortunately, within the last 50 years, mental health has undergone major changes and now offers a
variety of therapies for those suffering from a condition. Most large hospitals will have an in-
staff psychiatrist to treat patients or to refer them to a psychologist who by therapy will help the patient
realize the cause of their problem. However, one does not need to go to hospital to consult a mental
health professional. If someone suffers from a minor mental health problem, such as panic attacks or a
particular phobia, they are just as likely to find the help they need on the high-street.

Both the psychiatrist and psychologist are well versed in psychotherapy, but only the psychiatrist can
prescribe medicine such as mood stabilizers or psychoactive drugs if needed. In recent years, creative
therapies like music, color or dance therapy have also proved successful for certain conditions. Art
therapy, for example, has proved effective in the treatment of patients with dementia.
On the face of the matter, it appears that the nations mental health should be better than ever but as times
change so do the conditions which appear. Post-traumatic stress disorder(PTSD) was unheard of 30
years ago, but now poses a major problem for soldiers returning from war or witnesses to major
accidents. This does not necessarily mean that this is a new disorder, but rather that a name can be given
to a condition which has been around for hundreds of years.
Another example of an old complaint recently being given a name is obsessive compulsive
disorder (OCD) in which sufferers have a compulsion to carry out certain actions, which for some may
seem strange like repeatedly turning on and off a light switch a given number of times before leaving the
house. Some disorders are not so old though, eating disorders such as anorexia are relatively new.
Mental health issues are often a result of the environment in which we live. Taking anxietyinto
consideration, it has been noted that the number of sufferers has increased dramatically as our lifestyle
gives us more to worry about.
The challenge faced by mental health workers in the coming years, is to continue the good work already
started and expand on it, particularly with regard to autism which currently affects around 1 in 88
children, yet remains incurable.
Why do you think there was so much stigma attached to mental illness?
Do you think creative therapies can replace traditional pharmacological treatments? Why?
Can you think of any conditions which are both physical and mental?
UNIT 9: DENTISTRY
www.whitesmiledentalclinic.co.uk
About us:
Welcome to our webpage. We are a group of specialists dedicated to excellence in the treatment
of oral diseases and conditions. We are able to offer a wide range of dental treatment as well as provide
advice on routine care of your teeth and gums. Please browse our website for further information on our
services and team.
Our team:
At White Smile Dental Clinic, we employ only professionals with advanced knowledge, education and
relevant experience. In case you need a dental check-up or are suffering from toothache, please make an

appointment with one of our dental surgeons, commonly referred to as 'dentists'. He or she will identify
the cause of pain and provide appropriate treatment.
If you do not need a check-up but only want some advice, please consult our dental hygienists. They
will offer you advice on how to take care of your teeth, how to brush them, how to use dental floss and
what paste to use to enjoy healthy and white teeth for a long time.
In the case you need your tooth root to be treated, our endodontist, who specializes in root
canal treatments, will first treat the tooth's pulp or nerve or remove them if necessary and then do
the filling of the canal.
When you don't like the look of your teeth because they are crooked, we suggest consulting
our orthodontist. She will assess the condition of your teeth and then order braces for you, which is a
custom made apparatus you will have to wear to straighten your teeth.
Finally, if one or more of your teeth are missing and you need dentures, they will be constructed by our
highly skilled dental technician, who will create them using a dental model.
Services:
At White Smile Dental Clinic we offer comprehensive dental treatment. When a dentist discovers
a cavity in your tooth during a regular check-up, which is caused by decay, an infection leading to the
destruction of the hard tissues of the tooth, he or she will remove the decayed tissue, clean the tooth and
do the filling. If the cavity is large and there is no possibility to do the filling, the dentist will extract the
tooth.
After the extraction, it is worth replacing the missing tooth taking advantage of one of the available
techniques. Highly recommended is a dental implant, which is a surgical component made of titanium,
mounted in the bone of the jaw to support a crown. Titanium has an advantage over other materials
because it can fuse with the bone through a process called osseointegration. An alternative solution to the
implant / crown combination is the use of a bridge which involves joining an artificial tooth to adjacent
teeth.
If you notice bleeding in the gums after you brush your teeth or see that your gum lines are receding, it
may indicate you are suffering from gingivitis. The condition itself is not very dangerous, but may
develop into periodontitis, which is a destructive disease. Please consult our specialists to receive advice
on treatment & prevention.
Are your teeth not as white as they used to be? Is your teeth's enamel discolored? Our skilled &
experienced staff will whiten your teeth using one of the available techniques. Just make an appointment
and you will regain your 'piano keys' smile!
 Discuss questions:
What do you think are the advantages & disadvantages of working in the field of dentistry?
What kind of knowledge is required to work as a dentist?

How often should you visit a dentist for a check-up?
UNIT 10: ENGLISH FOR NURSING

Interview with a nurse.
Presenter: Welcome to today's episode of medi-chat. Today we will be continuing our series on the
different professions in health care and we are joined by Mary Jones, a staff nursefrom Birmingham
Hospital. Hello Mary.
Mary: Hello, thank you for having me on the program.
P: Thank you for joining us. Now to get us started, could you tell our listeners a little bit about why you
became a nurse.
M: Well, I always wanted to work in health care and nursing seemed like a good fit for me. I originally
planned to train as a midwife, but I decided that I liked the variety of treating and dealing with different
kinds of patients.
P: What do you mean by a good fit?
M: I like working with people and being a nurse allows me to interact with a lot of patients in one day. I
also feel like I am making a difference as I am giving direct care
P: I imagine it is quite demanding working so closely with patients.
M: Yes, it can be but it is also very rewarding when you get to help a patient from the time
of admission right through until when they are discharged.
P: Yes, that must give you a great feeling. But what are your actual duties? How do you help patients?
M: Ha, that would be a very long answer as every day is different but my main duty is assisting doctors
and monitoring patients. This may be collecting specimens from patients or administering medicine
which was prescribed by the doctor.
P: You mean giving out pills and tablets?
M: Well, that is part of it - but often medication is through an intravenous drip, so I have to place the
needle in the patients arm and make sure that the drip is flowing properly.
P: I see. So which duty do you enjoy most?
M: Actually, it may sound strange but I think I like to educate patients more than anything else. We get a
lot of patients who end up in hospital as a result of poor lifestyle, so as well as treating them my personal
challenge is to show them how to avoid a return trip. It is really satisfying when someone says something
like: 'Ok, I'll stop smoking'.
P: Does that happen very often?

M: Unfortunately not, I do seem to spend most of my time drawing blood or changing dressings. You
know, the routine stuff.
P: And what about the worst part of the job?
M: That is easy, being in the room when the doctor informs the patient or their family that the condition
is terminal. My charge nurse said that it gets easier with time, but I still find it very distressing.
P: Yes, I can imagine. So I assume you need to be quite strong emotionally to do your job.
M: Definitely.
P: Are there any other important characteristics that a potential nurse should have?
M: Yes, as we spend a lot of time around patients who are going through a hard time - a good bedside
manner is essential. You must remember that these are people with feelings. You also need to be
decisive as you often have very little time to choose the correct response to a patient's situation.
P: It sounds very difficult.
M: It is, and actually that is something that does annoy me - a lot of people just don't realize how hard it
is to be a nurse and in fact doctors sometimes look down on us.
P: Well, I for one appreciate the work done by nursing professionals. The last time I was in hospital I
was fortunate enough to have a very good nurse, and it really did make the whole experience much less
frightening. Thank you for telling us about your job.
 Discuss questions:
What other nursing duties do you know of?
What qualities do think are important in a good nurse?
Why do you think nurses are often less respected than doctors?
Conversation between two nurses:
Gary: Oh, hello Brad. I didn’t know you were working a morning shift today too.
Brad: Hi Gary, yes, I’ve just finished, and I am glad the work’s over. It’s been rather a tough day in my
ward. How was it in yours?
G: Same. But we can’t expect it to be easy, can we?
B: You’ve got a point there. So what did you do today?
G: Well I arrived earlier than usually and the nurses from night shift were still filling out the reports, so I
waited at the reception and chatted to Jackie, do you know her?
B: She’s new, isn’t she? I haven’t met her yet as last week I attended a 3-day workshop on
pharmacology and I think she started then.

G: Oh yes, the workshop. Anyway, when my shift began, I had to provide some hands-on care to the
older patients in my ward. You know, some of them have problems washing and dressing.
B: I know what you mean, I do it from time to time only as there are fewer elder patients in my ward
than in yours. Our boss always says we should proceed in such a way so as to keep their dignity intact.
G: That’s indeed very important to make them feel safe and comfortable. Afterwards, I dressed some
minor wounds of a patient after a traffic accident and later on had to provide pre-operation care to
another patient who was about to undergo appendectomy. It was also my task to obtain informed
consent from her regarding anaesthesia, which I found rather challenging as I had difficulties in
developing rapport with this particular lady.
B: Were successful with the consent?
G: Yes, I was, and the patient has already undergone surgery. If there are no complicationsshe will be
discharged in two days.
B: Do you have any special procedures regarding the convalescents in your ward?
G: Hmm, let me think. Oh yes, we need to instruct them how to self-administer medications after they
return home. Moreover the supervisor of our ward pays special attention to the provision of
emotional support, especially in cases when recovery is going to require patient’s determination and
may be painful.
B: Right. What was the second half of your day like?
G: Well, it was much less busy I must say. There was just one more patient who had reported to the A&E
department himself but was later transfered to our ward. I only needed to evaluate his symptoms
and devise a sound treatment plan. Finally I filled in some documents as we have to keep records about
every patient’s condition. Ok, enough about me! How was your working day?
B: Well, my day was completely different than yours, as instead of working with patients, I had to do
some work which is more technical than medical.
G: Technical? What exactly do you mean?
B: Well, the supervisory nurse ordered me to carry out routine maintenance of the equipment in our
ward.
G: Maintenance? What kind of maintenance can you do on a stethoscope?
B: Ha ha ha, very funny. Try carrying out maintenance on a pump or a drainage system and then we will
talk. It’s absolutely essential to do it in order to ensure smooth operation of the equipment and I am sure
it is also routinely done in your ward. Anyway, it took me almost three hours to complete. Afterwards I
went through our inventory and realized we were about to run out of some supplies for example
bandage, disinfectant and such, so I placed an order at a wholesaler.

G: Well, that doesn’t sound too bad! Anyway, it was really nice meeting you Brad. Have a good evening
and see you tomorrow.
B: Yes, see you!
What key tasks do nurses do in their jobs?
What are the challenges that nurses may face in their jobs?
In what way can the job of a nurse be rewarding?
English for Nursing 2
The role of nursing in healthcare has changed dramatically in the last 20 years as nurses have taken on a
wider range of duties and responsibilities. Caring for the sick has become more complicated, hospitals
are more understaffed and budgets are tighter which means that often nurses are taking on the duties of
junior doctors as well as their own work.
These changes are particularly visible in public healthcare where increasing rates of diabetes, obesity and
other conditions connected to the modern life has put a strain on healthcare workers dealing with the
growing number of complex illnesses.
Partly because of the increased workload and partly because nurses still earn a relatively low salary when
compared to other medical professionals, fewer people are entering the nursing profession which has led
to shortages of well-trained staff and deficiencies in many hospitals. In recent years, this issue has been a
major problem in the care of the sick. In an effort to combat this problem, local governments and large
hospitals have started offering incentives for people studying nursing. These incentives range from
payment of tuition fees to a down payment on a house and have proved very effective in reversing the
tendency of fewer and fewer new nurses graduating each year.
This increase in the demands placed on healthcare workers and specifically nurses has led to the need for
greater abilities and better training. Nowadays, many nurses are pursuing medical specializations such
as pharmacology or preventative counseling, which enables them to provide a higher standard of care to
their patients. Of course, this doesn't mean that nurses should be thought of as being fixed to one area of
medicine as the majority of nurses working in the public sector are multi-skilled and are just as
comfortable dispensingmedication as they are assisting in the rehabilitation of patients or preparing
them for surgical intervention.
In fact many of the traditional roles of nurses are still valid today, such as helping a bedridden patient go
to the toilet or aiding in the sedation of a patient, but their workload has increased significantly. Patients
now have a greater knowledge of basic medical issues thanks to online doctors and medical
encyclopedias, so now when the average patient is admitted to hospital they already believe that they
know what is wrong with them and more often than not the condition is acute. Or worse still
patients self-prescribe and then complain that the illness is not responding to the treatment. On the face
of it, this sounds like the medical staff would have less work as the diagnosis has already been made, but

in reality this diagnosis is often incorrect and leads to nursing staff having to convince the patient that
their symptoms don't fit to that condition, an often time-consuming process.
And this is not the only case where technology has made nursing a harder profession. Nurses are now
called upon to order and interpret blood work and other laboratory tests, a duty which traditionally fell
on the doctor. Take the example of x-rays, modern machines are now capable of performing between 3
to 7 tests in the same time it took the previous generation of machine to do one, this means that the
person interpreting the results has at least 3 times the amount of work to do.
New initiatives in some leading hospitals aim to tackle these situations by curbing high costs, and
reducing demands on nursing staff connected to chronic disease care by home monitoring programs
whereby patients are monitored via the internet in their own home, freeing up beds and reducing the cost
and time invested in these patients. Although these programs are in the early stages, the signs are
promising with both patients and medical staff seeing the benefits.
Another trend in preventative medicine is the increase in screening which is often done in the community
rather than in the hospital and allows direct contact with patients who may not otherwise have gone to
hospital. Screening is particularly effective in detecting early signs of tumors and other growths, of
course at this stage they cannot show if they are malignant or benign but the tumor is discovered.
As we move forward through the 21st Century it is imperative that authorities continue to find ways to
make nursing as attractive a profession as possible to ensure that hospitals are well-staffed by qualified
and interested nurses.
Do you agree that nursing is seen as a less attractive profession than being a doctor? Why?
What else could be done to encourage people into the nursing profession?
In your opinion, are monitoring programs where the patient is monitored via the internet and not kept in
hospital a good idea?
UNIT 11: ROUTINE CHECKUPS

Website except
Welcome to www.annualcheckups.org. The main aim of our website is to offer advice on the required
or recommended check-ups that everyone should have annually. You will learn why you should treat
check-ups as a mandatory activity and depending on whether you are a woman or man which diseases
you can screen for. Moreover, you will obtain information on how to prepare to a check-up so that it is
effective and reliable.
Why check-ups matter
Is there anything more important than your health and the health of your relatives? Of course there isn’t,
so it’s time you took charge of your health and scheduled an appointment with your doctor to discuss
the tests and screenings you need. This will help identify health problems before they start or at their
early stage, when you have better chances for a successful treatment. This is the best thing you can do to
stay healthy!
How should I prepare?
First of all you need to review your family health history. It is one of the most important risk
factors for serious health problems such as heart disease, stroke, diabetes and cancer. When you present
your family health history to your specialist, they will assess the risk of a disease and recommend
measures you can take to prevent it, such as doing exercise, changing your diet and so on.
What are the fundamental things to check?
Regardless of your gender, the one thing you should get is an annual blood test. It is the most important
step an adult person can take to prevent life-threatening diseases, as its results can help you notice any
critical changes in your body before they manifest as a serious health issue.
There are many blood tests you can get, but the most important ones are the complete blood count,
the chemistry panel and the fibrinogen. Let’s now explain what each procedure involves. The complete
blood count offers information on the number, percentage and concentration of platelets, red blood cells,
and white blood cells. Therefore, it is useful in the detection of such health disorders as an infection and
anemia.
The chemistry panel gives information on such parameters as total cholesterol, high-density and low-
density lipo-protein (HDL and LDL) or blood glucose. This can help detect problems such as diabetes
and coronary artery disease.
The fibrinogen level test’s importance cannot be underestimated as well. The level of fibrinogen
increases when tissue inflammation occurs, and since atherosclerosis and heart disease are inflammatory
processes, this test can help assess the risk of heart disease and stroke.
With the blood test done, you should also screen for various types of cancer, some of which may affect
both men and women, e.g. colorectal cancer. There are a few screening methods to detect it, of
which colonoscopy is most accurate. You should have the test done if you are over 50, or younger if
there were cases of colorectal cancer in your family.
One other thing everyone should monitor regardless of their gender is their Body Mass Index - BMI.
With obesity being a serious social issue in developed countries, it’s good to be aware whether you are
overweight and should think about your diet more carefully. You don’t need to consult a specialist in
order to calculate your BMI - simply use the calculator that can be found in the ‚Extras’ section of our
website.
I am a woman, what should I check?
If you are a female, then apart from the aforementioned tests and screenings, you should have a BRCA
genetic test done. This is the test of two genes, BRCA 1 and BRCA 2, which are responsible for the
production of tumor suppressor protein. When these genes are mutated or altered in any way, cells are
more likely to develop genetic abnormalities leading to cancer, in particular breast cancer. Another type
of cancer that women should screen for is cervical cancer. The test which facilitates its detection is
called a Pap smear and it should be done every three years.

I am a man, what should I check?
If you are over 50, you should definitely get screened for abdominal aortic aneurysm, especially if you
have ever been a smoker. Abdominal aortic aneurysm, or AAA for short, is a bulging in the body’s
largest artery - the abdominal aorta. AAA may burst which can result in severe bleeding or even death.
To verify whether you are at risk of AAA occurrence, you can have ultrasound examination done, which
is absolutely painless.
A type of cancer that is male-specific is called prostate cancer. The test commonly used to screen for it
is called DRE, which stands for digital rectal exam. It involves a manual examination of the rectum to
estimate the size of the prostate and feel for any lumps or abnormalities.
What are the fundamental tests and screenings recommended for both men and women?
What male-specific and female-specific check-ups are mentioned in the article?
What are the benefits of having regular check-ups?
UNIT 12: AT THE PHARMACY
A dialogue between a pharmacist and a customer:
Pharmacist: Good morning. How can I help you today?
Customer: Hello. Can you fill a prescription?
Pharmacist: Certainly. I see that you need several items - let me check if we have them all. I will be right
back.
Pharmacist: Well, Mr. Jones we have most of the items but I see that your doctor prescribed you brand
name antibiotics and we only have the generic variety, will this be ok?
Mr. Jones: Um, what's the difference?
Pharmacist: The drugs are actually the same, both varieties use the same active ingredientsand are taken
in the same manner. The only real difference is the cost, the generic are much cheaper.
Mr. Jones: That sounds good. Oh, but what about side effects of the generic one?
Pharmacist: The side-effects are the same with both drugs; the most common one being drowsiness. Of
course, you should read the instructions before taking and pay close attention to the contraindications as
this drug has a few.
Mr. Jones: Ok, so I will take the generic antibiotics and what about the other items?
Pharmacist: We have the eye-drops, the anti-inflammation suppository and the liniment. I must say that
this seems like an unusual combination of treatment.
Mr. Jones: Ah, well you see it is not just for me. The prescription is from our family doctor and covers
me, my wife and our son.

Pharmacist: Now I see. Ok, so I just need to tell you a little about these drugs. May I ask who the
liniment is for?
Mr. Jones: That's for me.
Pharmacist: Ok, well this is a transdermal liniment which means you need to apply it to the area and the
active ingredient is absorbed into your bloodstream.
Mr. Jones: Ok, and it should only be applied to a small area of skin?
Pharmacist: Yes, that is correct. Just follow the instructions on that. Now, the eye-drops - these
are topical...
Mr. Jones: You mean they may be unsafe?
Pharmacist: You would be surprised how often people try taking them orally.
Mr. Jones: I assure you that I know how to use eye-drops.
Pharmacist: Right, sorry I didn't mean to cause offense. Anyway, the suppositories are a little more
unusual. Are these also for you?
Mr. Jones: Absolutely not. They are for my wife.
Pharmacist: Ok, well please tell her that she must follow the dosage instructions on the box and if at any
time she starts to feel numb, she should discontinue the treatment.
Mr. Jones: Of course.
Pharmacist: So that's everything from the prescription. Is there anything else I can do for you?
Mr. Jones: Yes, I need something for a blocked nose and do you have anything to help the immune
system cope better?
Pharmacist: There are several options for boosting the immune system but as you don't have a
prescription it will have to be an over-the-counter remedy. I would recommend 'rescue remedy'
Mr. Jones: What is it?
Pharmacist: It is a tincture of alcohol and herbs.
Mr. Jones: So it is natural?
Pharmacist: Yes, and it is very good. I use it on my daughter during the flu season.
Mr. Jones: Ok, that sounds good.
Pharmacist: And for the blocked-nose, of course a nasal spray to clear the nose and maybe a vitamin
C dietary supplement as well.
Mr. Jones: That would be good, but it's for my son and he cannot swallow tablets.
Pharmacist: No problem, these are effervescence tablets so they dissolve in water.
Mr. Jones: Perfect. How much will that be?
Pharmacist: 49.92 with tax.
How useful do you think natural remedies are in preventative medicine?
Should pharmacists be allowed to substitute generic drugs for brand drugs? Why / why not?
In your opinion, do people take too many over-the-counter drugs? Why / why not?
UNIT 13: ENGLISH FOR EMT'S
The importance of EMT's and Paramedics
Whether it be an ambulance rushing through the downtown traffic or a fire truck screaming along the
highway, or a rescue chopper soaring over the mountains - we all know that there are people in trouble
and the brave EMT's and paramedics onboard these vehicles will do everything they can to save them.
But how many of you have considered what this actually involves? EMT's are often depicted on TV as
the Macgyvers of the medical world able to cope in any situation, using only the limited selection of
tools at their disposal, and while this is true it would be wrong to think that any of their activities are
spontaneous or not thought-out. Each and every response is a testament to their training and knowledge.
At the time of a call out, it is impossible to predict the exact situation they will be walking into so all
EMT's are trained to cope with the unexpected in a methodical and calm way. They may arrive on the
scene of a highway accident in which multiple casualties are present, the EMTs may need
to extricate patients from their vehicles and then prioritize the seriousness of each injury, to do this
an LOC (level of consciousness) test is often used.
Once all casualties have been assessed and placed in a safe position, it is up to the EMT's to stabilize the
patients through the most viable course of action. This stabilization which can be offered depends on
whether it is provided by an EMT or a paramedic as the paramedic has had more extensive training and
can even provide minor surgical interventions such as a nasogastric intubation , or use
an AED (automated external defibrillator) something which an EMT basic is forbidden from doing.
However, both the EMT basic and the paramedic are well trained in procedures to suppress bleeding
or remediate breathing using ventilation. Both kinds of healthcare workers are also able to
perform CPR (cardiopulminary resuscitation).
Once the initial treatment has been given, the patient needs to be prepared for transport which in itself
can be a challenge. Many patients who have been involved in accidents may have suspected damage to
their spine so they need to be secured to a cot to prevent movement. If a patient appears jaundiced, it
may be a sign that they could vomit during transport so it is important that their airways be kept clear.
Fortunately, modern rigs contain a wide array of devices which can be used in both the treatment and
movement of patients so EMTs onboard are well equipped.
Once the patient is en-route to the hospital, it is crucial that the EMT's apprise the hospital of what to
expect so that the doctors and nurses on duty can be ready and waiting to continue the treatment. The

driver of the ambulance has to balance the necessity for high speed with the need to make the ride as
comfortable for the patient as possible.
As with everything in healthcare, paperwork is also generated by these runs with EMT's having to fill out
a run-sheet each time they are called out on an emergency run with basic information about the patient,
the complaint and any action taken, and a face-sheet each time a patient is taken to hospital showing that
all relevant details have been provided to the hospital.
And once all that is done, the day is still not over for the EMT as the ambulance needs to be disinfected
and any items used during the run need to be replaced.
As you can see, the life of an EMT is far from boring.
What are the main duties of EMTs?
What characteristics do you think are important for EMT's / paramedics?
How has modern technology helped EMTs?
An interview with an EMT about a recent call out
M: Hello and welcome to today’s episode of ‚A day in the life’, a series which looks at a typical daily
routine of various professionals. My name’s Mark Brookes and our guest today is Francis Goodman,
who works as an EMT at Stanford General Hospital. Welcome to the program, Frank.
F: Hello Mark, hello everybody.
M: First of all let me just say we are all very glad you accepted our invitation. To start off, could you tell
our listeners a few words about yourself?
F: Certainly. I’m 32 and I’ve been working in A&E department for 11 years. I began my career as an
EMT-B but after a few years I took a course to become an EMT - I.
M: In this program we talk to specialists in various fields and ask them to give us an overview of their
typical day. So what is your typical day like, Frank?
F: That’s a tough question Mark, as in this line of work, there’s no such thing as a typical day. I can tell
you about yesterday and this will give you insight in what me and my workmates do. Will this be OK?
M: Good idea Frank. So what was yesterday like? Were you called out to an emergency?
F: Yes, indeed we were, and this was actually a major event that you must have heard of, as it was on the
news all the time.
M: Do you mean that dreadful pile-up on Interstate 10?
F: Yes, that’s right. It was about 10 in the morning and we were just hanging out in our base when
the dispatcher instructed us to go immediately to the scene. Do you know what happened exactly?
M: Not really, I only heard there was one fatal casualty.

F: Yes, unfortunately the person suffered immediate death and we weren’t able to help him. What
happened was that a SUV crashed into a truck transporting ammonia, which as you know is
highly hazardous. As this happened near traffic lights, two more passenger vehicles then crashed into
the SUV. The thick fog must have been the reason why they didn’t manage to brake in time.
M: That sounds terrifying.
F: Yes. The SUV driver was speeding at the time and he crashed into the truck so badly that the
ammonia tank started leaking, causing burns to some victims as well as poisoning.
M: So what did you do first after you arrived at the scene?
F: Well as usual we had to make an accurate assessment of the situation and as soon as we realized there
had been an ammonia leakage, we informed the firefighting services. Then we identified who suffered
injuries and took vital signs of the victims.
M: When taking vital signs, what exactly do you look at?
F: We first check LOC, which stands for level of consciousness, depending on whether the victim is
unconscious or conscious and able to communicate. Then we examine breathing and take pulse, as well
as look at pupils.
M: Pupils? You mean the part of the eye?
F: Exactly, the little black spots in our eyes. We check whether they are dilated or constricted, in other
words, smaller or bigger, and how they react to light.
M: Oh yes, I understand. So what happened next?
F: With the assessment completed, we began to provide care to the victims. The sight was really
terrifying due to the ammonia leakage and one of the members of our team was not able to maintain
his composure. It was a new person and this came to him as quite a shock, so we told him to stay in the
ambulance. We took care of those badly hurt in the first place. The most important thing was to control
the bleeding and in one case, a paramedic had to perform an on-site blood transfusion. The next task we
had to do was bandage injuries, and in case of those victims with fractures, splint the broken bones
and immobilize the limbs.
M: Then I guess you gave the necessary medicine before setting off to the hospital?
F: Yes, but in order to do so, the paramedic had to calculate the dosage and then administer the
recommended medicine. We EMTs are not allowed to do that. When the medicine was administered and
the victims carried on board ambulances, we drove to the hospital.
M: Thanks you very much for telling us about the event, Frank. My impression is that your job can be
both very rewarding and very traumatic at the same time, as on the one hand you help people and save
lives, but on the other you witness so much sadness and pain.
F: I couldn’t agree more, Mark.

What are the most important duties of an EMT?
What vital signs can an EMT take after the arrival to the patient?
EMTs sometimes claim their work is underestimated. Why do you think it may be so?
UNIT 14: ELDER CARE

As a result of modern medicine finding new cures and treatments for illnesses and diseases which used to
be incurable, a new challenge has presented itself in the form of an aging population. The increase in the
number of people living into their 80s, 90s and beyond has led to a greater demand for professional
eldercare workers and geriatric specialists.
If you are considering a career in either of these specialties, there are a few things you should know.
Working with the elderly, whether in a hospital setting, a hospice or in residential care can be
incredibly rewarding but it takes a special skill-set to cope physically and emotionally. On the physical
side, care workers need to have the strength to turn bedridden patients so as to avoid the patient
developing bedsores and to help infirm patients to the bathroom when needed, while also being aware
that patients who are suffering from osteoporosis must be moved in a careful manner. Whereas from the
emotional side, all care workers need to be able to connect with their patients and offer
them companionship.
Although it may seem that companionship is less important than physical care, the truth is very different.
In fact patients in residential care, may only have interaction with their care workers and it is this
interaction which helps to keep their cognitive functions working correctly. This is especially true in the
case of patients with dementia, who need regular conversation and company to help hold back the signs
of the condition and with family members often living far from them, this duty is assumed by the carer.
If the family live closer, a carer can be faced with another challenge as often the next of kin and the
patient do not agree on the best course of care, which can lead to additional stress on the patient.
As well as the more common duties like monitoring and administering medication regimens, a care
worker also needs to feel comfortable in a variety of duties from bathing and grooming ]through to
changing bed sheets for the incontinent, and all the while bearing in mind that for their patients these
activities can be degrading. It is common for elderly patients to suffer from functional disability, in
which they are unable to carry out a certain action - even though, they are physically able. In these
situations, it is vital to maintain the dignity of the patient.
Another factor to consider is the added difficulty in working with patients who often suffer from
multiple ailments and impairments. If you are prescribing a drug for one condition, you must be aware
of the possible outcomes on the other pre-existing conditions and whether or not the drug is safe to take
in combination with the patients existing prescriptions. For example, there are certain medications
for glaucoma which cannot be used if the patient has anemia.
If this sounds too demanding, there is another option in the form of respite care. More and more often
after a stay in hospital, seniors are checking into respite care while they recuperate. Working in this
setting offers the advantage of working with different patients each month and hopefully helping them to
recover enough to return to their lives outside of a care home.
As you can see a career in elder care is not an easy option, but it does offer the carer a chance to work
with interesting people and while it may not always be possible to 'cure' your patients, you can make
their lives more comfortable and give them the chance to enjoy their twilight years.
What are the specific challenges of working with the elderly?
Do you agree that eldercare work could be more rewarding than other areas of health care? Why/ why
not?
In your opinion, should elderly relative live with the family or should they live in a specialist care home?
Why?
UNIT 15: HOSPITAL ADMINISTRATOR

Letter of application
Dear Sir or Madam,
I am writing with regard to the advertisement of the hospital administrator vacancy posted on
www.careerlink.com on 22nd September. As an experienced healthcare facility manager, I believe I am
a strong candidate for the position.
Your advert specifies that you are looking for an experienced healthcare unit manager with
relevant background. I graduated from St. John’s University, Bradsfield, in 2002, where I obtained a
master’s degree in management. Afterwards I enrolled on an MBA course with a specialization in
Healthcare Management in order to broaden my knowledge. The course took two years and it included
topics such as healthcare policy, information management in healthcare, economics and financial
management.
Having been awarded the MBA in 2004, I began my career by doing an internship at a small medical
practice in my hometown, which let me hone my professional skills. It lasted 12 months and as an
assistant to the manager of the facility, I was responsible for implementing procedures developed by
my supervisor. Additionally I took part in the recruitment process and assisted in job interviews held by
the general manager.
After the internship I applied for the position of the manager of a hospice for children, which I obtained
after a three-stage interview. It was a very challenging but rewarding occupation, due to the nature of the
facility. My main management duties included budgeting and fundraising for the facility, and as the
financial means allocated to the hospice by the state were insufficient, unfortunately I had to
limit expenditure, which proved to be a difficult task. In order to collect the means necessary to support
the facility I was in charge of, my team and I organized several events involving sporting activities as
well as auctions.

After 4 years in the position of the hospice general manager, I applied for a post of a hospital
administrator at Josephine General Hospital, a large facility with 12 departments, which provides
healthcare services to over 600 patients at a time. The main reason for changing the job was that I
believed I had enough expertise to manage a large unit and further develop my skills. As the hospital
administrator, I have to liaise with the medical staff, heads of departments and the governing board.
Moreover it is my task to assess risk connected with financial decisions, mitigate conflicts that occur
among staff members and oversee the work of lower-level managers in charge of individual departments.
I also establish standardsof practice and make sure all employees comply with them.
As the contract I have with the hospital expires at the end of this month, I am looking for a new facility
where I could apply my expertise. I am confident I would make a valuable employee at your healthcare
unit thanks to my extensive professional credentials. Moreover, I am hard-working, ambitious and able
to work efficiently under pressure, which is a vital quality in healthcare administration. I am a creative
problem-solver and have highly developed interpersonal skills, which allows me to motivate staff
effectively and communicate with people from various cultural backgrounds and educational levels. I am
well aware of the specificity of the job of a healthcare unit manager and am able to work flexitime,
including nights and weekends if such a necessity arises.
Should you find my application interesting, please contact me to arrange an interview. I am mostly
available in the afternoon, but am able to rearrange my schedule so as to come to your facility at a time
convenient to you.
I attach my up-to-date CV as well as references provided by my previous employers. I look forward to
hearing from you.
Kind regards,
Stephen Bradley
What are the main duties of a hospital administrator?
What pros and cons of this job can you see?
Would you like to work as a hospital manager? Why/why not?
UNIT 16: MEDICAL SLANG
A dialogue between two nurses at the nurses' station in the city hospital:
RGN Mary: Hi Sarah, how was your shift?
LPN Sarah: Oh, hello Mary. It was a nightmare, I ended up pulling a double shift and haven't slept in
almost 30 hours. And for the last 6 I have been dealing with this goldbrick I'm exhausted!
Mary: Yeah, I remember those days well. Look on the bright side, in less than 6 months you will have
completed your RGN training and those days will be behind you.
Sarah: I can't wait, I've had enough of being an LPN!

Mary: Was it very busy last night?
Sarah: Yes, we got hammered with that train derailment and of course we had the usual frequent
flyers just looking for attention.
Mary: Someone should do something about them. I mean we have a hard enough time treating people
who actually need it, let alone those who don't.
Sarah: I know, but what are you going to do?
Mary: True.
Sarah: Oh, and we had two bouncebacks
Mary: Who?
Sarah: Mr Jones, you know the one with the velcro and Miss Spencer
Mary: I thought the slasher had finished with Miss Spencer
Sarah: He had, but it didn't help. She still has the same symptoms.
Mary: So what is happening with her?
Sarah: Well, Dr. Singh was shotgunning last night so we will see if that turns anything up.
Mary: And what about little Jimmy? Has his condition improved?
Sarah: No, I'm afraid he was discharged up just after midnight.
Mary: Oh no, the parents must be devastated.
Sarah: They are. I actually felt sorry for Dr. Evans, he tried everything when Jimmy was circling the
drain but he just couldn't save him, and then he had to break the news to the mother. It was tough.
Mary: Yes, I can imagine. So this means we have a free bed? Sarah: No, we admitted a guy with
an appy this morning. He is due to go into surgery at midday.
Mary: What's he like?
Sarah: He seems nice enough, but apparently he got quite angry when the paramedics performed
the wallet biopsy.
Mary: I'm not surprized. I would feel exactly the same.
Sarah: Yes, but it has to be done. You know the gatekeeper wouldn't let an uninsured patient be treated
here.
Mary: I know. So after his operation he can be transferred to recovery?
Sarah: Yes, they already know he will be turfed later on today.
Mary: Great. And has the consultant seen Mrs Timms?

Sarah: Yes, but he reached a zebra.
Mary: What does he think it is now?
Sarah: Churg Strauss Syndrome.
Mary: What? Surely it is an ILI.
Sarah: That's the logical diagnosis but you know our consultant. If it's not exotic, he isn't interested.
Mary: I would love to give him a piece of my mind but the last time I contradicted him he started calling
me a noctor.
Sarah: I hate it when he gets all condescending like that, but you know it's not just us nurses he looks
down on, he behaves the same way with his puppies.
Mary: Yeah, last week I overheard him telling one of them to do a full run-up on the albatrossat the end
of the hall and then complaining that the intern couldn't diagnose the guy.
Sarah: Anyway, I'm just about finished so I am going to pop by the departure lounge to try and catch
Joe before his shift finishes.
Mary: Ok. Well, have a nice couple of days off. And get some rest! (intercom) : Paging nurse Mary,
please report to ward A, we have a code brown.
How would you feel if your nurse / doctor described you as an albatross?
Why do you think so much slang is used in medical language?
Do you agree that doctors look down on nurses? Why/why not?
UNIT 17: ADHD AND ASPERGER'S SYNDROME

What Is The Difference Between Asperger's Syndrome and ADHD?
It’s not uncommon for people to wonder whether someone they know has either Asperger's
Syndrome (AS) or Attention Deficit Hyperactivity Disorder ADHD. The two share many similarities,
and even for a trained professional it is not always easy to tell them apart.
What makes AS and ADHD appear so much alike is the fact that both conditions involve a disturbance
of two processes, executive functioning, and information processing. Executive functioning refers to the
brain’s ability to regulate, control and manage other processes, such as planning, attention, problem-
solving, inhibition, mental flexibility, task switching, and initiation and monitoring of actions.
Information processing involves how the brain gathers, manipulates, stores, retrieves and classifies
information.
The fact that problems with executive functioning and with information processing are common to both
disorders may explain why, by one estimate, roughly 60-70 percent of children with AS have symptoms
that are similar to children with ADHD.

The similarities between AS and ADHD include:
Impulsivity Distractibility inattentiveness
delayed social sensitivity to sound, light and Problems following

skills texture directions
Tantrums Learning problems Problems with coordination
In as much as the two conditions share many similar features, there are differences between them. Here
is a list of those differences:
Multiple Delays: Children with AS have delays in many different areas of their development unlike
children with ADHD who are primarily affected by problems of distractibility and impulsivity.
The delays in AS involve gross and fine motor skills, integration of sensory stimuli, socialization, play,
management of mood, and communication. It is true that children with ADHD can have problems in
these areas but they are usually not as many or as severe.
Distractability: Children with AS tend to focus their attention on one task or activity. By contrast,
children with ADHD are typically distractible. Their attention is drawn away from a task or activity by
surrounding noises, movements, and other distractions. They tend to jump from one activity to another
unlike the more focused nature of children with AS.
Emotionality: Children with AS do not typically show a wide range of emotions while those with
ADHD often move back and forth among emotional states and may have difficulty controlling these
emotions.
Listening: Making and sustaining eye contact is usually difficult for children with AS. They often appear
not to be listening when they actually are. In contrast, children with ADHD may appear not to listening
but for different reasons. They are easily distracted by things going on around them or by their own
thoughts.
Language: Children with AS tend to have weaknesses in their understanding of non-literallanguage.
They have trouble grasping jokes, slang or implied meaning. They also tend to be talkative, but usually
about topics of interest to them, while taking turns in conversations and talking about a topic of interest
to someone else is more difficult. Children with ADHD are more able to take turns in conversations and
switch topics to accommodate someone else’s interests. They have an easier time understanding non-
literal language.
Socializing: Because of the difficulty that children with AS have socializing, they tend to avoid many
social situations. Being around other people is stressful, especially with peers. Children with ADHD

may have trouble fitting in with peers because of their behavioral difficulties but they are more motivated
to interact with others.
Sensory Difficulties: Children with AS often are overly sensitive to sounds as well as lots of visual
stimuli and some textures. Their sensitivity leads them to get easily overloaded when lots of things are
happening around them. On the other hand, children with ADHD often respond better when their
environment is highly stimulating. Unlike those with AS, children with ADHD do not often seek out
sensory experiences in a repetitive or eccentric manner.
Of course, this list of differences involves a number of generalizations. Not all children with either AS or
ADHD respond exactly as other children do with the same condition. Whatever their diagnosis, these
children tend to be challenging for parents, and what is most important is that they receive the love,
tolerance, understanding, patience and informed interventions they each deserve.
This article was used with permission by the author, Dr. Kenneth Roberson, a psychologist in San
Francisco with over 30 years of experience.
Original Article is at http://www.kennethrobersonphd.com/difference-aspergers-adhd
You can buy his book Adult Asperger's Syndrome here
http://www.kennethrobersonphd.com/book/

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UNIT 1: THE HUMAN BODY

Extract from Anatomy course lecture

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Lung cancer is particularly common among smokers.

Epilepsy is a potentially fatal disorder of the central nervous system.

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She was taken to A&E on suspicion of appendicitis.

Before we begin, you will be administered a local anesthetic.

UNIT 4: DIAGNOSIS PART 1,2

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UNIT 8: MENTAL HEALTH

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UNIT 10: ENGLISH FOR NURSING

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UNIT 11: ROUTINE CHECKUPS

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UNIT 14: ELDER CARE

UNIT 15: HOSPITAL ADMINISTRATOR

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UNIT 17: ADHD AND ASPERGER'S SYNDROME

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Impulsivity Distractibility inattentiveness

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Tantrums Learning problems Problems with coordination

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