I was talking to a nurse and OET candidate yesterday about some of the aspects of the role plays which cause a few difficulties. While we were talking, I had an 'aha' moment...one of those times, when you realise something which is only obvious, when you know it.
Let me explain. For a lot time now, I have been teaching medical English expressions, which we (nurses in Australia and the UK - my experience) use, when talking about patient care. One of them is 'encourage independence'. You will hear this expression a lot, when talking about the elderly or less able patients. The idea is that we, as nurses, physios, doctors, OTs etc, want to ensure that we don't take away a person's ability to care for themselves. It may be that they need some help (you will hear expressions like:
* 'needs prompting to eat' - this means, that you will need to say something like 'Here's your lunch, Mrs Smith. Would you like to start with the sandwich?'
* 'supervise medication, shower, toileting etc' - this means that you may need to watch the elderly person to ensure that they take their medication or have a shower
* encourage mobilisation - you will need to encourage the elderly person to walk to the toilet, for example, rather than expect to be taken in a wheelchair
* encourage independence with ADLs - you will se this expression written in care plans and clinical pathways.
I had always assumed that this was standard nursing practice all over the world, but I realised yesterday, that I was making CULTURAL assumptions. I was told that in some countries, e.g. Singapore and China, almost the opposite is the the norm, Nurses do not encourage independence, if an elderly patient is in hospital, for fear that they might have a fall. To do otherwise is viewed as promoting unsafe practice.
The conversation started me thinking about how this might affect a candidate who is doing a role play for the OET. The candidate may not understand prompts which tell them to 'encourage independence'.
Another thing we talked about yesterday was home services and home aids. Before we practised a role play, where I played the part of the caregiver (daughter) of an elderly person returning home after a knee replacement. We talked about the sort of suggestions which the nurse could make regarding assistance at home. For example:
1. bathroom modification. It's not enough to say 'I'll arrange an Occupational Therapy visit to discuss home modifications.' You need to know their names and how to describe them. It's a good idea to go on a website which sells aids for the bathroom and other rooms. For instance, the Allianz website.
* toilet seat raise - 'This will make it easier to sit on the toilet.'
* grab rails -'You can hold onto the grab rails to keep you steady.'
* non-slip bath mats - 'These help prevent slips in the bathroom.'
Another topic you may discuss with patients is Meals on Wheels - the service which delivers food to client's homes. The service has changed in later years, so that frozen meals can be delivered as many or as few days a week as needed.
And so on. Do some research about what is available and write out some expressions you might use during the role play.
Dementia and role plays
Do some research about what is available in the community to help people with dementia and their carers. Alzheimers Australia is a very useful website. In New Zealand, it's the Alzheimers New Zealand Charitable Trust as well as websites, such as Dementia Auckland. Research local services and support groups you can recommend to patients or their carers.
In summary, make sure that you can demonstrate an understanding of the cultural setting as well as the language needed. Be aware of the cultural expectations of a nurse, physio, OT etc - in other words, show that you are encouraging independence.