MODULE 3

WOUND CARE: DESCRIBING PROCESS

At the end of the lesson, you should be able to:

1. understand the importance of using therapeutic communication strategies to explain how to do

something.
2. apply therapeutic communication strategies to give instructions to patients.

A. Warming up.
1. The charge nurse is going to help the patients with washing and grooming.

blanket brush comb hand cream kidney basin pyjamas

razor shampoo toothpaste towel washbowl deodorant
disposable wipes make-up mirror nail brush shaving cream
soap swab washcloth dressing gown nightdress
toothbrush

a. b. c. comb d. comb e brush f. hand

washbowl disposable cream
wipes

g. soap h.tooth i. kidney j. shampoo k. nightdress l. dressing

brush gown

m. n. o. towel p deodorant q. mirror r. nail brush

blanket washcloth
 s. t. razor u shaving v make-up w pyjamas
toothpast cream
e

2. Label the photos with the activities from the box.

A. applying a dressing B. ear syringing C. taking a swab

ear syringing taking a swab applying a dressing

3. Scan the text “Nursing in Today’s World’ and rank these nursing jobs
from highest to lowest.

a. Nursing officers 5

b. Auxiliary nurses 2

c. Student nurses 1

d. Staff nurse 3

e. Charge nurse 4

Nursing in Today’s World

Nowadays nursing is a career with a three-or four-year training,

qualifications, grades, unions and pensions. In some Western countries,
every nurse is on a grade. The grade depends on the nurse’s experience
and skills, and each grade has different responsibilities and pay.
 On the bottom grade are unqualified auxiliary nurses who do the routine
work in the hospital wards. On the top grades are nursing officers, who are
usually administrators. Auxiliary nurses are on the bottom grades, but
student nurses get the lowest pay. However, students don’t stay at the
bottom of the pay scale forever. When they qualify, they start working on a
middle grade. As they gain more experience, they can get promoted and
move up the ranks to become a staff nurse, then sister or charge nurse and
perhaps eventually a nursing officer.

Many nurses work shifts, and they often work overtime to earn additional
income. After their basic training, many nurses choose to do further study
and become specialists in a particular field or area. Nurses can in fact
specialize in many different fields. For example, they can become triage
nurses working in Emergency Departments or psychiatric nurses who treat
the mentally ill. There are also health visitors who visit patients in their own
homes, practice nurses working in GP surgeries and also midwives who
deliver babies.
Many nurses say they do not get enough pay and respect for the work they
do. They say that the work is physically and mentally demanding and that
they work long hours and get very tired. However, nurses will also say that
there are many great rewards which have nothing to do with money and that
nursing is an incredibly satisfying career.
Grice, T. (2007). Nursing. Oxford University Press: Oxford.

4. Read the article again and decide if these sentences are true (T) or false (F).

a. The more responsibility you have, the higher your grade. T/F
b. Nursing officers are the same as auxiliary nurses. T/F
c. Students are paid less than auxiliary nurses. T/F
d. Many nurses say that the job is rewarding, but the pay is low. T/F

5. Look at the sentence starters in the box below.

Take turns to choose one of the sentence starters and complete the sentence
about yourself. Try to add as much detail as you can. Take turns to ask follow-up
questions and keep each other talking. Keep going until all the sentence starters
have been used.

One day, I hope to I go to The subject I’m studying at I want to be a nurse

 Arabia for worship the moment that I like the because I want to work
most is family nursing that beside making
money also get reward

In the future, I’d like to What I really enjoy The hardest aspect of
build my house into 2
about holiday is family nursing is patient
floors
analysis

I’m particularly interested in What I think is most Next year, I want to go on

Hajj
evrything related to rewarding about a career in
hemodialysis nursing is confidence and
good comunication skills

An area of nursing I An area of nursing I’d be What I think I’m really good
wouldn’t like to interested in is at is comunication skills for
emergency nursing hemodialysis related trush with patient

6. Review the rules for modals of obligation. With a partner, match these
examples with rules that need to be followed in a hospital.

must We use must in rules and to say when things are necessary.

mustn't / must We use mustn't to say it is necessary that you do NOT do

not something.

have to We use have to talk about things that other people oblige us to
do.

don't have to We use don't have to say something is not necessary.

need to We use need to say it is necessary to do something

a. We must follow procedures more carefully = to say when …things

are necessary…..…

b. Sorry. I have to go. I'm on duty in ten minutes. = to say when …………………

c. You must not forget to put gloves on= to say when. ………………………………

d. We need to clean the floors more often = to say when. …………………………

e. You don't have to wash her face. She can do it herself = to say when………….
 f. All visitors must wash their hands before entering the ward. = to say when ……….
………

7. With a partner, review rules for a hospital environment. Decide what level
of obligation is required for each rule. Check your answers with another
pair and discuss why you chose your answers.

a. You must wear a nurse’s uniform while on duty.

b. You must have a name tag on your uniform.

c. You'll have to mop the floor- there's been a spill.

d. The patient don’t have to smoke after surgery. It won’t help his recovery.
e. You must dispose of rubbish the bins. They are full and overflowing.

f. You have to fill the soap dispenser in the bathroom. It’s empty.

g. You need to turn off your mobile phone when you enter the hospital.

h. You must change your gloves after contact with each patient.

8. Imagine you are working in a hospital. The Ward Sister has asked you to write a
notice reminding nurses about good hygiene practice. Write a list of rules and
instructions for the nurses on your ward. Write at least 10 rules using a variety
of modals from above.

HOSPITAL NOTICE
1. You must report all spillages immediately.
2. All visitors have to leave the ward by 8pm.
3. Visitors and nurse must wear masks in the hospital area.
4. Visitors must be orderly
5. No smoking in the hospital area
6. Nurses are not allowed to use handphone while working
7.
 B. Describing Process
1. Changing a wound dressing is a clean procedure. Always wash your hands
after each phase. Rearrange the series of wound dressing steps below. The
first and the last steps are given.

a. First, clean your hands with soap and water or hand sanitizer.
b. After you put on your third set of gloves, apply normal saline dressing to the
damaged tissue.
c. Once you have cleaned the wound, examine it to see if there are changes in the
wound. Report if there is increased drainage, change in the color of drainage or
if there is new odor or change in odor.
d. When the skin protectant is dry, apply the secondary dressing and apply the
tape to the dressing.
e. After that, take off your gloves and clean hands again. The next step is to put on
new the second set of gloves and gently clean the wound as ordered by your
doctor. Go around from the inner side to the outer side. After that, discard the
gauze.
f. Then, use the first set of gloves and gently remove the old dressing and discard
it.
g. The following step, remove the second set of gloves, clean your hands again h.
and put on the third set of gloves.
h. Don’t forget to set out supplies in one clean area close to you before you start.
i. Also apply the skin protectant around the wound and let dry.
j. Finally, remove the third set of gloves and clean your hands again .

Your answer:
B. USEFUL LANGUAGE EXPRESSIONS
Today, we’re going to learn how to explain a process effectively to patients
and or to a colleague, especially in giving clear instructions.

Here are some useful expressions we can use.

Purpose of instructions
Before you start explaining the process, be sure you share the purpose of
instructions. To do this, we can say:

I would like to show you how to ____

Today, we’re going to learn how to ____
Let me show you how to ____.

Clear Steps
When explaining a process, be sure the steps are organized systematically to
make it easy to follow. To do this we can say:

First, _______
Then, ______
Next, ______
After that _____
Also _____
Once you finish _____
Finally, _____

Guiding or showing the steps

Guide the patient how to do each step. To do this, we can say:

This is how to do it.

(It’s) like this.

Checking understanding
Don’t go too fast. Stop after several steps to check the understanding of the
person following the instructions. To do this, we can say:

Am I going too fast?

Is it clear?
Shall I repeat the last step?
Are you still with me?
Did you get that?
Giving a chance to the other person to try
After a demonstration of a step or a series of simple steps, give opportunity
for the other person to try the step or the series of steps. To do this, you can
say:

Now, it’s your turn.

Why don’t you try it?
Let’s see how you do it.
Can you try it?

Giving appreciation
After the other person tries a step correctly, give him or her words of
appreciation.

Good job.
That’s right.
Well done.
You did well.

Giving feedback for improvement

If you think the other person has to repeat the step, you can say:

It’s okay. Let’s try again.

Why don’t you try again? This time, don’t forget to ____
Don’t worry, we can try again.

C. Model Dialog: Complete the blanks with the expressions below.

Self-care of Burns and Abrasions (Scrapes)
A. I’m going to show F. Then, what
you
B. a fast learner G. Finally
C. pay attention to H. what do I do next
the way I do it.
D. Is it this one I. Are you still with me?
E. you do it like this J. How are you feeling today?

Nurse : Good morning, Mrs. Drake. (1) ____________

Patient : Much better, thank you.

Nurse : That’s great. Your wound is dry and healing fast. So, I think, when
you get home, you can do it yourself. Please do it once a day.
Patient : I don’t know if I can do it by myself.
Nurse : Don’t worry. Ma’am. You can do it. (2) ______ how to do it in simple
 steps.
Patient : Okay, then. Let’s begin.
Nurse : First of all, always remember to wash your hands before you
change your dressing with soap and water, or hand sanitizer. If you
use hand sanitizer, (3) _____. Now, you try.
Patient : All right. Is it like this, right?
Nurse : That’s right. You got it. If you have gloves, you can put on a set of
clean gloves.
Patient : Can I buy the gloves in any pharmacy or drug stores?

Nurse : Sure. In fact, I will give you several pairs to start with before you
buy new ones.

Patient : Thank you. That would be helpful. (4) _____?

Nurse : Next, clean your wound with a soapy washcloth. Please, (5)
______.

Patient : Oh. I see. It doesn’t look very difficult. (6) ___?

Nurse : Then, dry your wound gently with a clean towel. (7) _____?

Patient : Yes. I got it. Dry wound with a clean towel, right?
Nurse : Excellent. You are (8) _____. Then, apply antibiotic to the wound.

Patient : Which one is it? (9)_____?

Nurse : That’s right, the normal saline. (10) _____, apply a dry, clean
bandage, like this.
Information Source: Patient education, caring for wounds, http://shcc.ufl.edu/services/primary-care/self-help-resources/health-care-info-
online/patient-education-wounds-caring-for/

D. PRACTICE: Matching
Besides changing wound dressing, there are many instances where you can explain
how to do something to a patient. This time it’s how to use a nebulizer.
Match the beginnings (A-E) to the endings (1-5) to complete the instructions on how
to use a nebulizer.

BEGINNINGS
A. First of all,
B. Now,
C. Next,
D. After that,
E. Finally,
ENDINGS
1. put on the mask and tighten the elastic straps so that it fits snugly around the
head.
2. inhale the mist until it’s finished.
3. fill the chamber of the nebulizer.
4. turn on the oxygen so the liquid medication turns into a fine mist.
5. attach the tubing to the oxygen outlet on the wall.

E. Explaining a process.
In this activity, work with a partner, and choose a process in simple steps to explain
to a patient or a fellow student nurse on how to do something. List down the steps
below. After that design a conversation of practice giving instructions on how to do
something. Don’t forget to apply the communication strategies.
Step How to do it