Syndrome of Irritation of the Abdomen

Symptoms can be general and specific. Weakness, fatigability are general symptoms as they are characteristics of numerous diseases.Pain in the right subcostal part (правоеподреберье) increasing on pressure is a specific symptom of acute cholecystisis. It is called Shetkin and Blumberg’s syndrome or syndrome of irritation of the abdomen.

Тема 4.9 Аудирование специализированных текстов

1.1

Stephen: Hello. It’s Mr. Connolly, isn’t it?

Mr. Connolly: Yes. That’s right. Stephen: My name’s Stephen. I’m looking after you today.

Mr. Connolly: Oh, Stephen. Right.

Stephen: I just wanted to make sure you know where everything is. Then I’ll come back and ask you some questions.

Mr. Connolly: Oh, all right.

Stephen: I see you already have your pyjamas on.

Mr. Connolly: Yes.

Stephen: That’s good. Here’s the nurse call. Just press the button if you need some help.

Mr. Connolly: Oh, all right.

Stephen: The bathroom is outside on your left.

Mr. Connolly: Err, OK.

Stephen: Do you need help to walk to the bathroom?

Mr. Connolly: Yes. I’m a bit unsteady on my feet.

Stephen: That’s OK. Just call me and I’ll help you.

Mr. Connolly: Thanks, Stephen.

Stephen: Is there anything else you need?

Mr. Connolly: Err, no I’m fine. Thanks. Stephen: All right. I’ll be back to ask some questions after your lunch.

Mr. Connolly: Right.

 

1.2

Nurse: All right now. Err, what’s your name?

Patient: It’s Alan Bennett.

Nurse: Bennett?

Patient: Yes.

Nurse: Oh, yeah. Here it is. I’ve got a few things I have to tell you.

Patient: Oh, all right.

Nurse: OK. You know about the nurse call?

Patient: Not really.

Nurse: Well, it’s here.

Patient: Oh, right.

Nurse: The bathroom’s out to the left. OK?

Patient: Err, OK.

Nurse: Look, I’m a bit busy now, I’ll finish this later. All right?

Patient: Err, yes.

 

1.3

Stephen: Mr. Connolly, have you got an ID bracelet on?

Mr. Connolly: Yes. Here it is.

Stephen: I just need to check your personal details. Can I look at your ID bracelet, please?

Mr. Connolly: Certainly.

Stephen: Can you tell me your full name, please?

Mr. Connolly: John Everson Connolly.

 Stephen: Right. That’s correct on the bracelet. What’s your date of birth, please?

Mr. Connolly: The 30th of November, 1934.

Stephen: 30th of November 1934, right. Now your hospital number is four, six, three, eight, one, and seven. I’ll just check that on the identity bracelet. Four, six, three, eight, one, five. Oh no, that’s wrong.

Mr. Connolly: Oh dear, better change that, then. Anything else?

Stephen: One more question. Do you have any allergies?

Mr. Connolly: Yes, I do. I’m allergic to morphine. It makes me very sick.

Stephen: Oh. If you’re allergic to something, you should have a red identity bracelet. I’ll change that for you right away.

Mr. Connolly: Oh, thanks, Stephen. I forgot to tell them about the allergy.

 Stephen: That’s OK,

 Mr. Connolly. That’s why we like to check everything carefully.

 

 

1.4

Stephen: Good morning, Mr. Bracknell. I’m here to do your admission Obs.

Mr. Bracknell; Obs?

Stephen: Observations. It’s your weight, temperature, pulse and respirations. Also, your blood pressure and oxygen sats - that’s the amount of oxygen in your blood.

Mr. Bracknell: Oh, right.

Stephen: I’ll weigh you first. Can you stand on the scales, please?

Mr. Bracknell: Yeah, sure. What’s my weight?

Stephen: Let me see. It’s 78 kilos.

Mr. Bracknell: Oh well, that’s all right. Stephen: Yes, that’s fine. Now, I’m going to take your temperature.

Mr. Bracknell: OK.

Stephen: I’m going to take it in your ear with this tympanic thermometer.

 Mr. Bracknell: That’s new.

Stephen: Yes. Can you turn your head to one side for me, please?

Mr. Bracknell: Sure. This side?

 Stephen: That’s fine. I’ll just wait for the beep. Right. It’s thirty-seven three.

 Mr. Bracknell: Now what?

Stephen: I’ll put the blood pressure cuff on. Can you roll up your sleeve, please?

Mr. Bracknell: Sure, no problem.

Stephen: Can you put your arm out straight? That’s it. I’ll put on the blood pressure cuff.

Mr. Bracknell: That’s for my blood pressure?

Stephen: Yes. The machine will read your blood pressure and pulse.

Mr Bracknell: OK. What’s the other lead for?

Stephen: It reads the amount of oxygen in your blood.

Mr. Bracknell: Oh, yes, I remember. Oxygen sats, right?

Stephen: Yes, very good. Can you hold out your hand, please?

Mr. Bracknell: This hand?

Stephen: That’s fine. I’m going to clip the lead onto your finger so it’ll give me a reading for oxygen sats.

Mr. Bracknell: Mm. So how are my readings? Are they normal?

Stephen: Let me see. Your BP’s a hundred and twenty over seventy-five. That’s quite normal.

Mr. Bracknell: That’s good. Is my pulse all right, too?

Stephen: It’s 68. That’s fine.

Mr. Bracknell: What about the oxygen?

 Stephen: Your oxygen sats are 98%. That’s fine, too. Now, I’ll just finish by noting down your respirations - they were 16 breaths per minute. I counted them while...

 

1.5

Bessie: Hello, Samira. I’m Bessie. I’m your nurse for today. How are you? Samira: OK, thanks.

Bessie: That’s good. I’m going to take your Obs. now.

Samira: What’s that?

Bessie: It’s your temperature, pulse and respirations - that’s how many breaths per minute - and your weight. 1 need to check your blood pressure and your oxygen sats, too.

Samira: OK.

Bessie: Right. I’ll just take your temperature with this special thermometer in your ear and wait for the beep.

Samira: What’s my temperature?

Bessie: Your temp’s thirty-seven three. That’s good.

Samira: Now what?

Bessie: I’ll get the rest of the information from this machine. Lift up your arm for me, please. That’s it. I’ll wrap the cuff around your arm.

Samira: Is that OK?

Bessie: Yes, that’s fine. Now, I’ll just clip this lead on your finger.

Samira: What’s that for?

Bessie: It measures the amount of oxygen in your blood.

Samira: OK.

Bessie: I’ll turn on the machine now.

Samira: What does it say?

Bessie: Mm. Your blood pressure’s one hundred over sixty-eight. That’s fine. Your pulse is 64. That’s OK, too. Your oxygen sats are 98%. That’s the percentage of oxygen in your blood.

Samira: Is that good?

Bessie: Yes, it’s fine. That’s all from this machine. I counted your respirations while you were watching the machine. Your resps are 18 breaths a minute.

Samira: 1 didn’t even know you were doing it.

Bessie: I know. OK, I’ll weigh you now. Samira, can you stand on these scales for me, please?

Samira: OK.

Bessie: That’s a good girl.

Samira: How much do I weigh?

Nurse: Let’s see. You weigh 45 kilos.

Samira: Am I finished now?

Bessie: Yes. That’s it.

 

1.6

Fay: Hi, Bessie. I took Samira’s 10 am Obs. for you.

Bessie: Oh, thanks, Fay. What were they?

Fay: Her temp is thirty-seven eight now.

Bessie: Oh. Her temp’s up a bit.

Fay: Mm. Her pulse is 64. BP is one hundred and ten over sixty.

Bessie: OK. Pulse 64, BP is one hundred and ten over sixty. What about her resps?

Fay: Resps are still 18. Oxygen sats are 98%. I’ve charted the Obs. for you.

Bessie: Oh. Thanks a lot.

 

 

2.1

Emile: Hello, Mr. Brodzik? Can you open your eyes, please?

Mr Brodzik: Urgh.

Emile: That’s it. I’ll just take off your oxygen mask. Do you know where you are?

Mr Brodzik: Hospital.

Emile: That’s right. You’ve had your operation. How do you feel?

Mr Brodzik: Cold.

Emile: That’s quite normal after an operation. I’ll get you a blanket.

Mr Brodzik: Mm.

Emile: There you are. Are you warmer now?

Mr Brodzik: Er, yes.

Emile: Are you in any pain?

Mr Brodzik: Mm... no.

Emile: That’s good. You had a painkiller before you left the Operating Theatre.

 Mr. Brodzik: Mm.

Emile: Do you feel sick at the moment?

Mr. Brodzik: No.

Emile: OK. Some people feel a bit sick after the anaesthetic. All right, I’m just going to take your Obs. again.

Mr. Brodzik: OK.

 

2.2

Rachel: Here we are, Mr Brodzik. You’re back on the ward now. How are you feeling?

Mr Brodzik: A bit better, thank you.

Rachel: Does your hip still hurt?

Mr Brodzik: Yes, my hip’s still very sore.

Rachel: I’ll get you some more pain relief for that.

Mr Brodzik: Thanks.

Rachel: How’s the dressing on your hip?

Mr Brodzik: It feels a little uncomfortable.

Rachel: That’s because the dressing has to be quite firm.

Mr Brodzik: Oh, I see.

Rachel: How does the IV cannula in your arm feel? Does it feel OK?

Mr Brodzik: Yes, but it’s a bit painful when the nurses put in the IV medications.

Rachel: Mm, it can be. I’ll get you an ice pack to put on it.

 

2.3

1

Nurse: How are you feeling?

Patient: Not great. Can I have some painkillers, please?

Nurse: Sure. Where does it hurt?

Patient: My lower back’s really aching.

Nurse: OK, I’ll get the tablets and a heat pack, too.

 

2

Nurse: How do you feel this morning?

 Patient: Awful. I’ve got a terrible headache.

Nurse: I’ll get you some pain relief.

Patient: Thanks. Can you turn off the light too, please?

Nurse: Sure.

 

3

Nurse: Are you all right, Mrs Jameson?

Patient: No. I’ve got a really bad stomach ache.

Nurse: Sit down on the bed and I’ll get you some pain relief.

Patient: Thanks.

Nurse: When did you last have some tablets?

Patient: I’m not sure. I think it was a few hours ago.

Nurse: That’s right. It’s on your chart here. It was five hours ago.

 

4

Nurse: How are you feeling today?

 Patient: My knee hurts a bit.

Nurse: Put your leg on this pillow and I’ll get some pain relief for you.

Patient: Oh, that’s better. It’s quite sore and it aches.

Nurse: OK, I’ll get some tablets for you now.

 

5

Nurse: How do you feel today?

 Patient: Well, I’ve got a bit of a sore throat.

Nurse: I’ll get you some pain relief for that.

Patient: Thanks, it’s really painful. Can I have a cold drink too, please?

Nurse: Sure. I’ll get some iced water for you.

 

6

Nurse: Are you feeling better today?

 Patient: Not really. My hands ache a lot.

Nurse: Would you like some pain relief?

Patient: Yes, please. My hands ache more in the mornings.

 

2.4

Helena: Mylene, can you check this IV bag with me, please?

Mylene: Sure.

Helena: Here’s the IV Prescription. It’s for Mr Lenworth.

Mylene: OK.

Helena: Right, so the Normal Saline finished at six o’clock.

Mylene: OK. 06.00 hours today, 2September.

Helena: Mm. A litre went through.

Mylene: OK. A thousand mils.

Helena: I’ve got the next bag here. It’s 5% Dextrose.

Mylene: Yes, 5% Dextrose. What’s the infusion rate?

Helena: 1 25 mils an hour. It’s going to run over eight hours.

Mylene: All right. It’s starting at 6.15.

 Helena: That’s it. I’ll sign here. Can you sign, too?

Mylene: Sure. There you are.

Helena: Thanks.

 

2.5

Mylene: Helena, could you please show me how to change Mr Lenworth’s IV bag?

Helena: Sure, Mylene. What’s the next IV infusion?

Mylene: The next one’s 5% Dextrose.

Helena: OK. How long will the infusion run?

Mylene: It’ll run over eight hours.

 Helena: That’s right. What’s the infusion rate?

Mylene: Well, it’s a litre, so that’s a thousand mils. It’s running over eight hours. It’ll run at 1 25 mils per hour.

 Helena: That’s right. How much fluid’s left in the current bag?

Mylene: I’ll just look on the infusion pump... um. There are 60 mils left.

Helena: When do we need to put up the next bag?

Mylene: In about 30 minutes.

Helena: That’s right, because it’s running at 1 25 mils an hour. I’ll show you how to put up the next bag...

 

 

2.6

Helena: All right, Mylene. Let’s get the next IV bag ready. Before we start, we need to wash our hands.

Mylene: Oh, right. Of course.

Helena: OK, now we can start. First, we’ll check the IV solution against the IV Prescription.

Mylene: OK. The prescription is for 5% Dextrose.

Helena: That’s it. Here’s the IV infusion. Can you check it with me? This is a bag of 5% Dextrose.

Mylene: Yes, I can see the label. 5% Dextrose.

Helena: Next, I’m going to prime the line. To prime the line, you run the IV fluid through the IV tubing of the giving set.

Mylene: The giving set has one end to go into the IV bag and the other end is for connection to the patient’s cannula.

Is that right?

Helena: That’s right. We’re going to run this IV infusion through an IV infusion pump. Next we need to set the rate on the infusion pump. What’s the rate, Mylene?

Mylene: The rate’s 1 25 mils per hour.

 Helena: That’s right. It’s an eight-hour litre. After that, I’ll start the infusion pump. Don’t worry, Mr Lenworth, the pump is just running a test.

Mr Lenworth: Oh, right. Noisy, isn’t it?

 Helena: Yes, it is. OK, that’s ready. Now, I’ll connect the IV to Mr Lenworth’s cannula. Then, I’ll start the infusion pump. All right, Mr Lenworth?

Mr Lenworth: Yes, that’s fine.

Helena: Now we both have to sign the IV Prescription.

Mylene: OK. Here?

Helena: That’s right. The last thing is to write up the Fluid Balance Chart.

Mylene: OK, I think I have all that.

Helena: Let’s go over it again. Can you tell me the seven steps we went through?

Mylene: Yes, I think I can. Before you start, wash your hands. First, check the IV bag against the IV order. Next, prime the line of the giving set. Then, set the rate on the infusion pump. After that, connect the IV to the patient’s cannula and then start the infusion. Finally, sign the IV Prescription and write up the IV infusion on the Fluid Balance Chart.

Helena: Well done.

 

3.1

Judy: Hello, Usha. How are you feeling today?

Usha: Hello, Judy. I feel a bit down today.

Judy: Oh, I’m sorry to hear that. Anything you want to talk about?

Usha: Well... um, I’m still in a lot of pain.

Judy: Oh dear, I see. You don’t think the pain is getting any better with your treatment?

Usha: No. I feel it’s getting worse.

Judy: Mm. Did you have radiotherapy yesterday?

Usha: Yes, in the morning. It made me feel quite sick.

Judy: Mm. I know. Radiotherapy can make you feel quite sick.

Usha: Mm. 1 don’t feel like eating at all.

 Judy: Why don’t I get you some medication for pain and nausea?

Usha: Yes, please. Then I might try to have a rest.

Judy: Good idea. I’ll bring you the injection right now.

Usha: Thanks.

Judy: Can I get you a cup of tea, too?

 Usha: Thanks, Judy. I’d like that.

3.2

Nurse: Hello, Janice. How was your chemo today?

Patient: Oh, it was OK, I suppose. Nurse: I’m sure you’re fed up with it by now.

Patient: Yes, I am. I am trying to cope but it’s hard.

Nurse: Cope with the chemo, you mean?

Patient: Yes. The chemo, feeling sick and being in hospital away from my family.

Nurse: Mm. Your husband was in to visit this morning. How’s he doing?

Patient: He’s having a few problems.

He doesn’t like to talk about my illness.

Nurse: That must be hard for you.

Patient: Yes, it is. Look, erm, thanks for listening. It’s good to have a chat. Sometimes it’s hard to talk to my family about how I feel.

Nurse: That’s OK. No problem.

 

3.3

Nurse: Did you buzz?

Patient: Oh, yes, sorry. I just feel a bit sick.

Nurse: Do you want an anti-emetic for that?

Patient: I don’t know what to do. 1 had chemo this morning.

Nurse: Oh no, look at the time. I’ve got to give out the meds. Do you want the anti-emetic?

Patient: Oh, I don’t know. 1 just feel a bit down, I think.

Nurse: Right, look, I’m a bit busy now. Your husband’ll be in soon, won’t he? Patient: Yes. Don’t worry. I’ll be all right.

Nurse: Good, right. I’ll see you soon.

 

3.4

... OK, now we’re up to Jim Sullivan in bed 3. Jim was admitted today for Palliative Care and pain control. He’s got cancer of the liver with secondaries in the spine. He was in quite a lot of pain when he first arrived. He said the pain in his back is a stabbing pain. He also has pain in the liver area and he describes this as an aching pain. Jim was taking regular analgesia at home but it’s not enough now. He rated the pain as 9 out of 10 when 1 spoke to him. Doctor Donnelly saw Jim this morning and ordered a syringe drive. I explained to Jim that this will give him a small amount of painkiller medication continuously. The subcut cannula for the syringe driver has been inserted into his abdomen. I checked Jim just before handover and he says the pain level is much better now. Jim’s had one injection of breakthrough medication this morning. He also finds that a heat pack on his back helps a lot.

 

3.5

Karin: Hello, Mr Summerville. My name’s Karin. I’m looking after you today.

Wilf: Hello, Karin. Call me Wilf.

Karin: How are you feeling today?

Wilf: I’m not too good today. I’ve got a lot of pain.

Karin: Oh dear, I’m sorry to hear that. I’ve brought a pain chart so you can explain your pain a bit better.

Wilf: Er all right.

Karin: Where’s the pain, Wilf?

Wilf: There are three areas which hurt.

Karin: OK. Can you tell me on a scale of nought to ten what is the worst pain you’ve had in the last twenty-four hours in each area?

Wilf: OK.

Karin: Can you show me the first one on the picture of the body?

Wilf: It’s my right shoulder.

Karin: OK. What’s the pain in your shoulder like?

Wilf: It’s a throbbing pain, not a sharp pain.

Karin: What sets the pain off?

Wilf: It starts when I move or lie in bed.

 Karin: How bad is the pain right now?

Wilf: Er, a six. I had to get back to bed because of the pain.

Karin: OK. I’ll label that pain ‘A’. What do you take for the pain?

Wilf: The painkillers help and heat packs are good, too.

Karin: OK. What about the next area?

Wilf: My lower back. It’s the worst pain.

Karin: Mm. It’s where the main cancer is, isn’t it?

Wilf: Yes. My back aches a lot.

Karin: I’ll label that pain ‘B’. How’s the back pain now?

Wilf: It’s eight at the moment.

Karin: When is it worse?

Wilf: When I move or sit in a chair.

Karin: Does the medication help?

Wilf: A little but not much.

Karin: That’s not good, is it? I’ll ask the doctor to check the medications for you. Wilf: Thanks. I might need some stronger painkillers.

Karin: Mm. What about the last area of pain?

Wilf: The leg ulcer.

Karin: OK, that’s ‘C. What starts the pain in your leg?

Wilf: It only hurts when the dressing’s changed.

Karin: What’s the pain like?

Wilf: It’s sharp - around a three out of ten.

Karin: What helps the pain?

Wilf: Those non-stick dressings are good. And I have painkillers before the nurse does the dressing.

 

3.6

Kelly: Ward 16, Kelly speaking.

Joyce: Oh, um, yes. It’s Joyce Gribble here. I’m Mrs Brenda Dixon’s next-door neighbour. Can you tell me how her CT scan went today?

Kelly: I’m sorry; I can’t give you any information about Mrs Dixon’s treatment.

Joyce: It’s all right, dear. I’ve been her friend for years. I’m sure she wouldn’t mind.

Kelly: I’m afraid I’m not allowed to talk about her treatment. It’s because of patient confidentiality. Perhaps you could speak to Mrs Dixon yourself.

Joyce: Oh, I see. Can I visit her?

Kelly: Yes, of course you can. Visiting hours are from 2 pm to 7 pm.

Joyce: Good. I’ll get a bus in today.

How is she feeling at the moment?

Kelly: She’s very tired but I’m sure she’ll be happy to see you.

Joyce: All right. I’ll be in later. Could you tell her l called?

Kelly: Sure. I’ll let Mrs Dixon know you called.

Joyce: Thank you, dear.

 

3.7

Ruth: M Wing East, Ruth speaking.

Elsa: Yes, hello. Could you please put me through to Mrs George?

Ruth: Are you a friend or relative?

Elsa: Oh, yes. I’m her sister. My name’s Elsa Fulton.

Ruth: I’ll just check what her extension is... 9316. OK. Can you please hold for a minute?

Elsa: Yes, certainly.

Ruth: Right... extension 9-3-1-6.

Mrs George?

Mrs George: Hello. Yes, its Mrs George here.

Ruth: Mrs George, I’m just putting your sister through.

Mrs George: Thank you. Hello, Elsa? Is that you, dear?

Elsa: Hello, Freda. How are you?

Mrs George: Oh, getting along nicely.

 

4.1

Angela: Morning, Mrs Briggs. It’s Angela. I’m here to do your dressing. Can I come in?

Mrs Briggs: Hello, Angela. I didn’t hear the door bell. Come on in.

Angela: I’ll just take a quick look at the wound to see how it’s doing.

Mrs Briggs: Thank you. I’ll put my leg up for you.

Angela: That’s good. I’ll take the bandage off first. Mm, well, it looks much better, doesn’t it?

Mrs Briggs: Ooh. It still looks awful to me.

Angela: Actually, the skin around the wound’s less red.

Mrs Briggs: Yes, I suppose so.

Angela: The wound’s got less pus in it

. Mrs Briggs: Oh well, that’s good.

 Angela: It doesn’t have a bad odour now because the infection’s better.

Mrs..Briggs: I noticed that.

Angela: The wound’s a bit smaller, too. 

Mrs. Briggs: That’s good news, isn’t it? 

Angela: It certainly is. Right, I’ll do the dressing now.

Mrs Briggs: Thanks, Angela. I’d like to have a shower.

 

 

4.2

Joe: All right, Mr Heath. I’ll help you to the bathroom so you can have a shower.

 Mr Heath: Thank you, Joe.

Joe: I’ll just get your walking frame for you.

Mr Heath: It’s over there.

Joe: OK. Up you get. That’s right. Do you want to go to the toilet first?

 Mr Heath: Yes, Joe. I think that’s a good idea.

 Joe: All right. Turn the walker around. That’s it. You can sit on the toilet now.

Mr. Heath: Ooh. The raised toilet seat f you brought last week is much better than the old one I had.

Joe: Good. I’ll take off your pyjamas while you finish.

 Mr Heath: Thanks. Um, nearly I finished.

 Joe: That’s OK. Finished now?

Mr Heath: Yes. I’m ready now.

Joe: I’ll wipe your bottom. OK, all I done.

Mr Heath: Thanks, Joe. It’s a bit embarrassing.

Joe: Don’t worry. No problem. Now, can you walk to the shower chair with your walking frame, please?

Mr Heath: Yes, right.

 Joe: Hold the grab bar in the shower. That’s good. I’ll put your walking frame outside the bathroom until we need it.

 Mr Heath: The grab bar’s useful, too.

Joe: Yes, it helps to have something to hold onto so you feel steady. Now, sit on the shower chair.

Mr Heath: OK, here we go.

Joe: I’ll just put your feet on the nonslip mat. I don’t want you to slip.

Mr Heath: Neither do I.

 

4.3

a

Nurse: Come on, lovie. Let’s get that nappy off.

Patient: Ooh, dear.

Nurse: Phew! That smells awful! What have you been eating?

Patient: I’m sorry. I didn’t mean to do it.

Nurse: Well, you’re very naughty, aren’t you? Oh, that’s disgusting.

Patient: Sorry, sorry.

 

b

Patient: Nurse, I didn’t ring the bell on time. I think I’ve wet myself.

Nurse: That’s OK, Mrs Crawford. These things happen. I’ll get a fresh pad for you.

Patient: I’m so sorry. It’s awful for you to have to do this.

Nurse: Don’t worry. It’s OK. I’ll sort it out for you.

Patient: I’m sorry.

Nurse: That’s all right. All done. I’ll put the call bell closer so you can reach it next time.

Patient: Thank you. You’re very kind.

 

c

Nurse: I’ll close the door to give you some privacy.

Patient: Thank you. It’s very embarrassing.

Nurse: That’s all right. No problem. Can you lift up for me and I’ll put the

bedpan under you?

Patient: Oh, um. Is that all right?

Nurse: That’s fine. Just press the call bell when you’re ready.

Patient: Thanks a lot.

 

 

d

Nurse: Come on now, no one can see you.

Patient: But they can. The door’s open.

 Nurse: Come on. Do a wee for me in the bottle like a good man.

Patient: I can’t, it won’t come out. I want the door shut, please.

Nurse: Now, now. Let’s do it quickly, shall we?

Patient: I can’t. I’m sorry. I just can’t like this.

 

4.4

Fiona: District Nurse Liaison, Fiona speaking.

Vivien: Hi, Fiona. It’s Vivien from the Alexandra Hospital.

Fiona: Hi, Vivien. How are you?

Vivien: Good, thanks. Have you got the fax with Mrs Bartle’s prescription yet?

Fiona: Let me see. Yes. I have it with me now.

Vivien: Great. Can you please pass on the prescription to the District Nurse who’ll be looking after Mrs Bartle? 

Fiona: Sure. So, she’ll need vitamin B12 injections every two months?

 Vivien: Yes. Vitamin В12, 1000 micrograms, intramuscular.

Fiona: And she’ll have the injections for six months. Is that right?

Vivien: Yes. She has an appointment with Dr Nuttall in six months for a check-up.

Fiona: OK. I’ll pass the prescription on to Sara. She’ll be looking after Mrs Bartle.

Vivien: Thanks. Can you also ask Sara to keep in touch with Mrs Bartle’s GP? Fiona: Yeah, sure. Dr Fildes is her GP, isn’t he?

Vivien: Yes, he is.

Fiona: All right. I’ll let Sara know when she comes back to the office.

Vivien: Thanks. Bye.

Fiona: Bye.

 

4.5

1

Nurse: I’ve got your discharge medication here, Mr Feldman. I just need to explain a few things to you.

Mr Feldman: Right. What have you got there?

Nurse: This one is your antibiotic.

Make sure you take it on an empty stomach.

Mr Feldman: Oh right. Take it before I eat.

Nurse: That’s right. Now, this is your inhaler. You must rinse your mouth with water after you use it.

Mr Feldman: OK. Clean my mouth after I use it.

Nurse: Mm hm. The last one is the lotion for your rash. It’s important that you shake the bottle so you mix the contents well.

Mr Feldman: OK, I’ll do that.

 

2

Nurse: Mrs Tinsdale, your medications have come up from pharmacy.

Mrs Tinsdale: Oh good. I was waiting for them.

Nurse: Right. I’ve got two medications. Here are the eye drops. They only last a month so remember to discard the contents after this date.

Mrs Tinsdale: OK. After September the 16th. I see.

Nurse: Don’t forget to keep the eye drops in the fridge.

Mrs. Tinsdale: Oh, yes. Thanks for reminding me.

Nurse: You’ve also got a tablet to take twice a day. You must avoid too much sun with these tablets. You could burn easily.

Mrs Tinsdale: Oh. OK.

 

 

5.1

Dr. Connor: Hello, Luisa. Can you tell me how Mr Kransky’s doing?

Luisa: Mr Kransky? Mm. He’s doing quite well but he still has difficulty swallowing.

Dr Connor: Mm. Has he seen the Speech and Language Therapist yet?

Luisa: Yes. He sees him every day to do tongue exercises to help his swallow reflex.

Dr Connor: That’s good. How’s he doing with the exercises?

Luisa: He’s doing well with the tongue exercises.

Dr Connor: What type of diet is he on now?

Luisa: He started on a pureed diet yesterday.

Dr Connor: How’s he finding the pureed diet?

Luisa: He’s managing well.

Dr Connor: Right. What about fluids?

Luisa: He’s still having thickened fluids and he’s coping quite well with them.

Dr Connor: OK. Erm... Can he feed himself yet?

Luisa: No, not yet. He still needs help with feeding.

Dr Connor: OK. I’ll write a referral to the ОТ.

Luisa: Thanks. Maybe she can bring a few things to help him feed himself.

Dr Connor: Yeah. Right. Can you continue with the pureed diet and thickened fluids until his swallow reflex is better?

Luisa: Sure. I’ll make a note of that.

Dr Connor: OK. I’ll review him at the end of the week.

Luisa: OK, thanks.

 

5.2

Debbie: Hello, Mr Gimlet. I’ve got your lunch for you.

Mr Gimlet: Oh good.

Debbie: Right. Are you sitting up comfortably in the chair?

Mr Gimlet: Yes, thanks.

Debbie: That’s good. Now, don’t rush, there’s plenty of time.

Mr Gimlet: That’s good.

Debbie: The OT’s sent a few things to help you feed yourself.

Mr Gimlet: Oh, yes?

Debbie: She’s sent a special bowl for you to try.

Mr Gimlet: Oh, what for?

Debbie: It’s a non-slip bowl.

Mr Gimlet: Oh, that’s a good idea.

Debbie: She’s also sent you a non-tip cup.

Mr Gimlet: All right, that’s useful.

 Debbie: There are some modified utensils for you to use, too.

Mr Gimlet: What, you mean those spoons?

Debbie: Yes. They’re easier for you to hold.

Mr Gimlet: Right, well, I’ll try them out.

 

5.3

Max: Hello, Mrs Hudson. I’ve brought you a brochure to help explain about how to swallow safely before you start on a pureed diet today. I’ll go through it with you now, if that’s OK?

Mrs Hudson: Yes. That’s OK.

Max: Before we start talking about swallowing, I’ll go through some of the parts of the head and neck.

Mrs Hudson: All right.

Max: First of all, the food enters the mouth. Then the teeth help with chewing the food.

Mrs Hudson: Right, yes.

Max: The tongue also helps with chewing and swallowing the food.

Mrs Hudson: I see.

Max: Then the soft food goes to the throat, which is at the back of the mouth.

Mrs Hudson: OK.

Max: The throat joins up with two separate tubes. One tube is called the trachea or windpipe. The other tube is called the oesophagus.

Mrs Hudson: Is that important?

Max: Yes, it is. I’ll explain about it in a minute.

Mrs. Hudson: Oh, right.

 

5.4

Max: Right, let’s move on to talk about a few tips for safe swallowing which I’d like to go through with you. Is that OK?

Mrs. Hudson: Yes. That’s fine.

Max: First of all, it’s really important not to rush meals. Take your time eating your food.

Mrs. Hudson: Right, I understand. Huh, take it slowly.

Max: That’s it. And eat small amounts of food several times a day. It’s better to eat smaller meals than larger meals.

Mrs Hudson: Why’s that?

Max: A person who’s had a stroke doesn’t always feel that food is going the wrong way into the airways. They don’t cough and so food can enter their lungs.

Mrs Hudson: Oh dear. Now I understand why I shouldn’t rush.

Max: That’s why you should eat the amount of food which fits on a teaspoon. Swallow all the food in your mouth before having another teaspoonful. It’s also important to keep food and liquids separate.

Mrs Hudson: What do you mean?

Max: Don’t drink and eat at the same time.

Mrs Hudson: I see.

Max: Try not to talk while you eat. Relax and enjoy your meal.

Mrs Hudson: I’ll make sure that I do. What else?

Max: After your meal, it’s a good idea to sit up for around thirty minutes to let your food settle.

Mrs Hudson: OK.

 

5.5

Dina: Hello, Mrs Noonan. How are you today?

Mrs Noonan: Not too bad, thanks.

Dina: Mrs. Noonan, I’m afraid I need to put a tube through your nose into your stomach now.

Mrs Noonan: It sounds awful!

Dina: I know, it’s not very pleasant but I’ll try to make you as comfortable as possible.

Mrs Noonan: All right.

Dina: I’ll show you everything I’m going to use so you’ll understand what’s happening.

Mrs Noonan: OK.

Dina: I’ll just turn off the TV so we’re not distracted.

Mrs Noonan: OK.

Dina: Here’s the tube which goes into your stomach.

Mrs Noonan: Ooh, it’s very long.

Dina: That’s because it has to go in through your nose and down into your stomach.

Mrs. Noonan: I see.

Dina: I’ll get you to swallow as I feed the tube through your nose.

Mrs. Noonan: I’m really nervous about this. I don’t know if I can do it.

Dina: It’s OK. I’ll stop if you need a break. Just hold up your hand and I’ll stop straight away.

Mrs Noonan: You will?

Dina: Yes. Just hold up your hand and I’ll stop.

Mrs Noonan: Right. I feel a bit better about it now.

Dina: All right. OK if I start now?

Mrs Noonan: Yes, go ahead.

 

5.6

Amanda: Mr Silverman, I need to write down what you had for lunch.

Mr Silverman: Oh, OK.

Amanda: Can I look at your menu?

Mr Silverman: Yes. Here it is.

Amanda: Right. How much soup did you have?

Mr Silverman: Er, the whole bowl. Amanda: Good. One bowl of soup, that’s 1 50 mils. Now, the main course was beef casserole and rice. How much casserole did you eat?

Mr Silverman: About half.

Amanda: OK. And the rice?

Mr Silverman: About half.

Amanda: Right. Half a serving of casserole and half a serving of rice. Did you have any vegetables?

Mr Silverman: No.

Amanda: Mm. Did you have any dessert?

Mr Silverman: Yes. Ice cream.

Amanda: Right. Did you have the whole tub?

Mr Silverman: Yes. All of it.

Amanda: Right. One tub is 80 mils.

Did you have a drink?

Mr Silverman: Yes. Apple juice.

Amanda: How much of the juice did you have?

Mr Silverman: Half a container.

Amanda: OK. That’s 55 mils.

 

5.7

Rhonda: Extension 567, Rhonda speaking. Can 1 help you?

Hannah: Hello. It’s Hannah calling from Ward 5. I’d like to make a referral to the Dietician, please.

Rhonda: Sure. I’m the Dietician.

 Hannah: Right, I’m calling about Mr Vermont in bed 301.

Rhonda: OK. What’s the problem?

Hannah: Could you review Mr Vermont, please? He’s lost a lot of weight in the last week.

Rhonda: I could come and see him at 3 pm today.

Hannah: Could you hold on for a minute while I check his notes?

Rhonda: Sure.

Hannah: Thanks for holding. I’m afraid 3pm is no good. He’s having an x-ray at 3.

Rhonda: Would 4 pm be OK?

Hannah: Yes, that would be better.

Rhonda: All right, I’ll see you at 4.

Hannah: See you at 4. Bye.

 

6.1

1

Nurse: Good morning, Mrs. Swift. I’m going to take you to the shower.

Mrs Swift: Thank you, dear.

Nurse: Do you use the walking frame to help you?

Mrs Swift: Yes. I do.

Nurse: All right. I’ll help you up now

 Mrs Swift: Ooh. Thank you very much.

 Nurse: That’s it. Hold the handles for me.

 Mrs Swift: There. I’m steady now.

 

2

Nurse: Hello, Mrs Wilson. How are you?

Mrs Wilson: Not bad, not bad.

Nurse: Would you like a short walk outside?

Mrs Wilson: Oh yes, thank you.

Nurse: I’ll get your walking stick for you.

Mrs Wilson: Yes, I need my stick.

Nurse: All right. Make sure the stick is firmly on the ground.

Mrs Wilson: Oh yes, I don’t want to fall.

 Nurse: Ready?

Mrs Wilson: Yes, ready.

Nurse: I’ll help you into the wheelchair, Gina.

Gina: Oh, thank you.

Nurse: Sit up and swing your legs over the side of the bed.

Gina: Ooh.

Nurse: That’s it. Now put your feet on the floor.

Gina: OK.

Nurse: Now, stand up and turn around to face me.

Gina: Oh, all right.

Nurse: That’s it. Now, sit down slowly on the wheelchair.

Gina: There.

Nurse: Right. You’re ready to go to Rehab now.

 

4      

Nurse: I’ll get you the crutches, Mark.

Mark: Thanks.

Nurse: Can you manage them all right?

 Mark: Yeah, I’m getting better.

Nurse: Just make sure the top of your crutches are a few centimetres below your armpits.

Mark: OK.

Nurse: If the crutches press into your armpits, they hurt a lot.

Mark: They sure do!

Nurse: The Physio’s going to take you for a walk soon.

Mark: Great. I want to move around a bit more.

 

6.2

Sally: Can Mrs Kovacs sit up in bed?

Lenka: Yes, she can. She uses the rope ladder to help her sit up in bed.

Sally: OK. What about Mrs. Hartley?

 Lenka: You’ll need the slide sheet to turn her in bed.

Sally: Mm. Can Ms Sayed lift up her bottom for a bedpan?

Lenka: Yes. I put a monkey pole on the bed for her.

Sally: Good. How do you get Mrs Phillips up?

Lenka: You have to use the hoist. She can’t move much at all now.

Sally: OK. Thanks.

 

6.3

Caroline: Hello, Mrs Kennedy. How are you this morning?

Mrs Kennedy: Not too bad.

Caroline: That’s good. I’m going to help you get up for your shower now.

Mrs Kennedy: All right.

Caroline: OK, hold the rope ladder with both hands.

Mrs Kennedy: Oh, yes.

Caroline: Great. Now, pull up so you are sitting.

Mrs Kennedy: Oh, oh.

Caroline: That’s great. Well done. Now, swing your legs over the side of the bed, slowly.

Mrs Kennedy: Ooh.

Caroline: That’s right; put your feet firmly on the floor.

Mrs Kennedy: Ooh. All right?

Caroline: That’s it. Here’s the frame for you. Now, hold onto the handles of the walking frame with both hands.

Mrs Kennedy: Oh, yes.

Caroline: There you are. Are you steady?

Mrs Kennedy: Yes, I’m fine.

Caroline: OK, you’re ready to walk to the shower now.

6.4

 

Julia: We’re just going to tuck the slide sheet under you, Mrs McKenzie.

Mrs McKenzie: Why?

Su: We’ll be able to lift you up the bed then.

Mrs McKenzie: All right.

Julia: First, roll over on your left side.

Su: That’s it, Mrs McKenzie.

Mrs McKenzie: Ooh.

Julia: That’s good. Su’s going to tuck in the slide sheet.

Su: OK. Ready.

Julia: Now, roll over on the other side.

Su: That’s it.

Julia: I’ll just pull the slide sheet through to my side.

Su: Now, just relax. Julia and I are going to help move you up the bed.

Mrs McKenzie: Oh, all right.

Julia: OK. One, two, three - lift.

Su: There.

Julia: Now, roll over again on your left side.

Su: That’s it. I’ll take out the slide sheet now.

Julia: OK. I’ll lift up the head of the bed so you can eat your lunch.

Mrs McKenzie: Thank you.

 

6.5

Bob: Hello, Walter. How are you this morning?

Walter: Not too bad.

Bob: That’s good. I’ve brought a hoist to get you on your feet for a short walk today.

Walter: Oh. Do I have to?

Bob: You’ll be fine, Walter. It’s important to mobilise quickly after your operation.

Walter: All right.

Bob: I’ll bring the hoist up close first.

Walter: OK.

Bob: Put your arms up and I’ll attach the straps of the sling to the hoist. Walter: Are they on?

Bob: Yes. Now, put your feet into your slippers.

Walter: OK.

Bob: Yes, that’s right. Now, relax and I’ll hoist you up.

Walter: Oh. That was easy.

Bob: Good, now hold onto the bars with both hands.

Walter: That’s easier with the hoist.

 Bob: Yes. You’re doing very well. Now, take a few steps.

Walter: All right.

Bob: Just go for a short walk today. Tomorrow you can go a bit further.

6.6

Bob: Ms Slessor was admitted to H Wing from a Nursing Home this morning. She’s an obese lady who needs quite a bit of assistance to mobilise. She uses a wheelchair as she is very unsteady on her feet. She needs the assistance of two nurses and the hoist for all moving and handling. We used a handling sling to get her up to a standing position from the wheelchair. We also used the handling sling to get her to sit over the edge of the bed.

Use a slide sheet to turn her or move her in bed as she is quite heavy. She needs the commode chair to take her to the toilet or for a shower. You’ll need the patslide to transfer her to a trolley when she goes for an X-ray this afternoon.

 

7.1

Marcus: Hello, Mr Desai. I need to ask you some questions before you have an angiogram.

Mr Desai: All right. What sort of questions?

Marcus: The questions are for the consent form for X-ray contrast.

Mr Desai: OK.

Marcus: Have you ever had asthma?

 Mr Desai: Yes. I’ve had asthma all my life.

Marcus: OK. Are you allergic to any drugs or food?

Mr Desai: Yes. I’m allergic to penicillin.

 Marcus: OK. What about allergies to food, especially seafood?

Mr Desai: Oh, no. I’m not allergic to any food. Seafood? Why is that important?

Marcus: The dye has similarities to seafood proteins.

Mr Desai: That’s interesting. But no, I’m not allergic to seafood.

Marcus: Have you ever had an injection of X-ray contrast before?

Mr Desai: Yes, I have. It was six months ago.

Marcus: Did you have a reaction to it?

Mr. Desai: Yes, I had a rash afterwards but they gave me some medication and I was fine.

Marcus: OK. Do you have heart disease?

Mr Desai: No, I don’t.

Marcus: Do you have kidney disease?

Mr Desai: No, I don’t.

Marcus: Are you diabetic?

Mr Desai: Yes, I am.

Marcus: Are you taking any medication for diabetes at the moment?

Mr Desai: Yes, I take tablets for diabetes.

Marcus: All right. I’ll make sure the radiologist knows before the angiogram.

 Mr Desai: Anything else?

Marcus: No, it’s N/A for pregnant or breastfeeding.

Mr Desai: Definitely.

Marcus: I just need you to read the information under the questions here, check and sign it for me.

Mr Desai: Right.

 

 

7.2

Laila: Hello, Mrs. Jessop. You’re having your CT scan today.

Mrs Jessop: What time is the CT scan?

Laila: It’s at 10.30. The porter’s coming in a little while, so I’ll help you get ready.

 Mrs Jessop: Do I have to take all my clothes off?

Laila: Yes, please. I’ll help you put on this gown. Just put your arms through the sleeves of the gown and I’ll tie it at the back for you.

Mrs Jessop: Thank you.

Laila: I’ll help you into the wheelchair. Here it is.

Mrs Jessop: Uh. Thank you.

Laila: I’ll just transfer your IV to the IV pole on the wheelchair.

Mrs Jessop: Oh, I forgot about that.

 Laila: I’ll just put the footplate down for you.

Mrs Jessop: Yes.

Laila: Lift up your feet and put them on the footplate. That’s it.

Mrs Jessop: My feet are cold.

Laila: I’ll put your slippers on for you

Mrs. Jessop: Thank you. How long is it going to take?

Laila: You’ll probably be in Radiology for about an hour.

 

7.3

1

Kenny: Hello, this is Kenny from the Coronary Unit here. Can I book an angiogram appointment for Mr Dunston tomorrow?

Radiology Clerk: Sure, what about 3.30?

Kenny: Mm, 4 would be better. He has an appointment at 3 and won’t be back in time.

Radiology Clerk: Let me see... erm, yes, 4 pm is fine.

Kenny: OK. Thanks.

Radiology Clerk: You’re welcome. Bye.

 Kenny: Bye.

 

2

Sheila: Hello, this is Sheila from Ward 1 4. Can I check when Ms Beverly Platt is having her ultrasound today?

Receptionist: Sure. It’s at 2.1 5.

Sheila: Oh, I thought it was 4.1 5.

Receptionist: No, definitely 2.15.

Sheila: OK, I’ll make sure she’s ready. Thanks. Bye.

Receptionist: Bye.

 

3

Veronika: Hello, it’s Veronika from 5C. Does Elizabeth Knight have an X-ray appointment tomorrow?

Receptionist: Yes, it’s at 5.1 5.

Veronika: I’m afraid she won’t be able to make it. She’s seeing the doctor at that time.

Receptionist: OK, I’ll cancel the appointment.

Veronika: Can I reschedule her appointment, please?

Receptionist: Sure. 3 p.m. tomorrow OK?

Veronika: 3 pm, tomorrow? Fine.

Thanks. Bye.

Receptionist: Bye.

 

7.4

1

Patient: Excuse me, could you tell me where I go for a blood test?

Nurse: Yes, sure. Go out of A&E, turn left and it’s next to Pathology.

Patient: Left, then after Pathology. Right, thanks.

Nurse: Yep, you can’t miss it.

Patient: OK, thanks.

 

2

Patient: Excuse me. I’m a bit lost.

Nurse: That’s OK. Where do you want to go?

Patient: I have an appointment at Outpatients.

Nurse: OK, you’ll need to go up to the second floor. Outpatients is in front of you as you get out of the lift.

Patient: Great, that sounds easy. I’m also looking for Maternity. My friend’s just had a baby.

Nurse: OK, it’s on the second floor, too. As you get out of Outpatients, go straight ahead. It’s at the end of the corridor.

Patient: Thanks very much.

Nurse: No problem.

 

3

Visitor: Excuse me, I’m looking for the cafe. My mother’s having an operation so I’d like to have a cup of tea while I wait for her.

Nurse: OK, go down to the ground floor, turn right as you get out of the lift and go past Security. You’ll see the cafe next to Occupational Therapy.

Visitor: Thanks very much. Oh, is there a gift shop here in the hospital?

Nurse: Yes, there’s a small gift shop on the ground floor opposite the Main Entrance.

Visitor: Thanks, I can find that.

 

8.1

Sheena: Good morning, Ms Simpson. How are you today?

Ms Simpson: Morning, Sheena. Nice to see you again. I’m fine, thanks.

Sheena: Great. I need to check your blood glucose level before you see the doctor. Is that OK?

Ms Simpson: Yes, that’s fine with me.

Sheena: OK, I’ll just put a test strip in the glucometer. Can you hold out your finger, please?

Ms Simpson: Here you are. This finger’s the best one, I think.

Sheena: I’m going to prick the side of your finger with this lancet.

Ms Simpson: Ah, sss.

Sheena: Now, I’ll put a drop of blood on the test strip. There.

Ms Simpson: Got enough?

Sheena: Yes, that’s fine. You can put the cotton swab on your finger now.

Ms Simpson: Thanks. What’s the reading?

Sheena: We’ll have to wait for the result to flash on the screen. Erm it’s 5.8.

Ms Simpson: That’s good. I’m happy with that.

Sheena: Yes, it’s fine. I’ll record it on your chart now.

 

8.2

1

Nurse: Do you mind if I take your blood pressure?

Patient: No, I don’t mind. I’ll roll up my sleeve for you.

Nurse: Thanks. That makes it easier.

2

Nurse: Is it OK if I do your dressing now?

Patient: Yes, that’s fine. I’ve just had a shower.

Nurse: Good. I’ve got everything ready for you here.

3

Nurse: Can I check your blood glucose level?

Patient: Sure. I hope it’s OK.

Nurse: It should be OK. It was OK last time.

4

Nurse: I need to see your identity bracelet. Is that all right?

Patient: Yes. Here it is. It’s on my right arm.

Nurse: Thanks. Yes... that’s all right.

5

Nurse: Is it all right if I give you this injection?

Patient: OK. It’s a painkiller, isn’t it?

Nurse: That’s right.

6

Nurse: I need to put up a new IV bag Is that OK?

Patient: That's OK. Is it the last one?

 Nurse: No, one more after this one.

 

8.3

Joan: Hello, Ms. Bhaskhar. Has it really been three months since I saw you last?

Ms. Bhaskhar: Yes, it has. Time flies.

Joan: I’ve got the lab results here for you.        

Ms Bhaskhar: Oh, right. How are the results?

Joan: Overall, much better than last time. Your glycated haemoglobin is 7%

Ms. Bhaskhar: Is that good?

Joan: Mm, it should be less than 7%.

Ms. Bhaskhar: That’s not good then.

Joan: Don’t worry, it’s less than the last time.

Ms Bhaskhar: OK. What about my cholesterol?

Joan: It’s 5.0, which is less than last time.

Ms Bhaskhar: What’s normal?

Joan: It should be less than five. A higher result may not be good for your heart.

Ms Bhaskhar: Oh. What about my blood pressure?

Joan: Let’s see. I’ll take it now. It’s a hundred and thirty over seventy.

Ms Bhaskhar: What was it last time?

Joan: A hundred and thirty over seventy, so it’s stayed the same.

Ms Bhaskhar: Well, that’s great. Do you think I’ve lost weight?

Joan: We’ll see. Hop on the scales. That’s great. You weigh 85 kg, so you’ve lost 5 kg.

Ms Bhaskhar: That’s good, isn’t it?

Joan: It sure is. What have you been doing to lose weight?

Ms Bhaskhar: I’ve been exercising more. I swim three times a week now..

 Joan: That’s really good. How do you find the new diet?

Ms Bhaskhar: It’s quite good actually.

I’m certainly eating less.

Joan: Terrific. I’ve made an appointment for you on December the 13th at 11 am. Is that OK?

Ms. Bhaskhar: Yes, that’s fine. I’m going to try to lose some more weight by the next visit.

 

8.4

Rosie: Hi, Jess. How are you this week?

Jess: Oh hi, Rosie. I’m a bit tired, actually.

Rosie: Mm. Sounds like a good time to have a chat about partying when you have diabetes.

Jess: OK. You’re probably right.

Rosie: Have you been going out a lot with your friends lately?

Jess: Yeah. I’ve been partying pretty hard. Uni’s finished for the semester and, well, ha ha, you know.

Rosie: Have you been drinking more alcohol than usual?

Jess: Yeah, I suppose I have.

Rosie: I need to talk to you about alcohol and diabetes. You have to be very careful or your blood sugars may drop too much. Alcohol can lower your blood sugars so you could have more hypos.

Jess: I have had a few lately if I have a big night out.

Rosie: Well, it’s good to know how much alcohol is safe to drink.

Jess: How much can I have?

Rosie: Well, women shouldn’t have more than 14 units of alcohol a week

 Jess: Oh, what’s a unit?

Rosie: A unit of alcohol is one standard glass of wine or half a pint of beer.

Jess: Oh, that’s not much, is it?

Rosie: No, it isn’t. Also, you shouldn’t drink on an empty stomach. Always have a meal or a snack while you’re drinking.

Jess: OK. I’d better plan my nights out a bit better from now on.

Rosie: Good idea. The other thing I need to talk to you about is recreational drugs. Taking drugs can be more harmful for diabetics than for non-diabetics.

Jess: Yeah. Honestly, I stay away from drugs.

Rosie: That’s good. You still need to understand what can happen just in case.

Jess: I suppose so.

Rosie: Taking drugs like speed or ecstasy can change your diabetes routine. You may not eat your meals on time or you may forget your insulin.

Jess: I wouldn’t do that.

Rosie: Well, it’s good to be aware of what might happen.

Jess: Which is?

Rosie: Drugs are like alcohol. They can make your blood sugars drop. You could have a hypo.

Jess: Mm. OK. I’ll be careful.

Rosie: That’s good. Ring me if you need to ask any questions, won’t you?

Jess: Thanks, Rosie. I know I can always talk to you.

 

8.5

Neil: OK, Mr Vega. I’ll show you how to use your insulin pen now.

Mr Vega: OK.

Neil: Before we start, we’ll wash our hands. OK, I’ve got everything ready on the trolley.

Mr Vega: Mm.

Neil: First, take the cover off the insulin pen.

Mr Vega: Right.

Neil: Now, use an alcohol wipes to clean the rubber seal on the end of the insulin pen.

Mr Vega: OK.

Neil: Now, screw the needle onto the end of the insulin pen.

Mr Vega: OK, now it’s put together, right?

Neil: That’s right. Next, you have to prime the insulin pen.

Mr Vega: What does that mean?

Neil: It means that you have to get the insulin right to the end of the needle.

Mr Vega: I see. How do I do that?

Neil: Firstly, turn the end of the pen to number two.

Mr Vega: Mm. Number two in the window.

Neil: That’s it. Then get the insulin to the end of the needle to prime the pen

 Mr Vega: OK.

Neil: That’s it. You can see the drop of insulin at the end of the needle.

Mr Vega: Yes.

Neil: Next, turn the end of the pen to dial the dose of insulin.

Patient: Right. I need twelve units. OK

 Neil: Now, pinch up some skin on your abdomen so it’s easier to inject the insulin.

Patient: Like this, so the skin’s raised?

Neil: That’s it. Hold the pen up and inject into the raised skin.

Patient: OK. Hold pen upright and inject.

Neil: Finally, hold in the button at the end of the pen and count to five so all the insulin goes in.

Patient: OK. One, two, three, four, five.

Neil: That’s it. Now you put the pen away until you need it next time.

Patient: OK. Do I have to keep the insulin pen in the fridge?

Neil: No. You mustn’t store the insulin pen in the fridge.

Patient: Oh, why’s that?

Neil: Insulin shouldn’t be too hot or too cold, so it’s best to store the pen at room temperature.

Patient: Right. So, what do I use the cool pouch for then?

Neil: Use the cool pouch when you travel so the insulin stays at the right temperature.

Patient: That’shandy.