Speaking Book
Speaking Book
Speaking Book
25 NURSING
PATIENT You are an 18 year old female with undiagnosed anorexia nervosa who has self pre-
sented to an emergency department due to severe heart palpitations which you’ve
never had before. Initially the doctors give you some heart drugs to slow your heart
back to a normal rhythm but they also now have an intravenous drip connected to you
which you are very anxious about and don’t understand. Generally you are very de-
fensive and angry in your interactions with staff and are in denial about having anor-
exia nervosa or any mental health problems.
TASK Ask the nurse about why you have a drip running and express fear that it
might harm you in some way.
When the nurse tries to make conversation with you about your eating habits,
initially answer some of his/her questions, but fairly quickly become defen
sive & angrily ask why it’s their business to know about your personal habits.
When the nurse tells you a psychiatric doctor will come to see you, become
angry again, protesting that these doctors are only for crazy people and that
there is nothing wrong with your mind. Calm down only when the nurse per
suades you that that your eating behaviour is now causing very serious prob
lems in your life.
NURSE An eighteen year old female with undiagnosed anorexia nervosa has presented to
your emergency department with an abnormal heart rhythm caused by her poor nutri-
tional status. Cardiac treatment has stabilised her heart but she is still currently re-
ceiving a potassium infusion via a drip to prevent further such problems. Other than
when she wants you to explain treatment to her, she is defensive and angry to com-
municate with and in denial that she has any kind of eating disorder or mental health
issues.
TASK Reassuringly answer her anxious questions about the intravenous drip
being given to stabilise her electrolytes.
Tactfully ask her about her eating habits and food intake, emphasising your
therapeutic aims for asking these questions.
Advise her that a mental health doctor will come to see her soon and when
she becomes angry about having to see a ‘doctor for crazy people’, try to
persuade her of the importance of dealing with her mental health/eating
issues to prevent such life threatening hospital admissions.
Role Player Card No. 26 NURSING
PATIENT You are the 30 year old parent of a four year old child (Mellisa). You were called
to her kindergarten as she had fallen from the playground equipment. You notice
that your child has a swollen forearm and you are concerned that it is broken.
NURSE This thirty year old parent is concerned about his/her child’s forearm, which appears
broken. The parent wants to know about the treatment and if the fracture will affect
future growth.
TASK Find out how it happened. Examination shows that the child has suffered a
greenstick fracture which will require a plaster cast and sling.
Explain
- future growth should not be impaired;
- approx. 6 weeks to heal;
- all normal activities ok, within limitations of wearing plaster
Role Player Card No. 27 NURSING
SETTING Hospital
PATIENT You are a 42 year old woman admitted with an exacerbation of chronic pulmo-
nary disease. You work in the insurance sector and have a very hectic and stress-
ful work life. You also have to take care of 3 school going children and find it
difficult to cope-up with work and family. Hence you can’t imagine quitting smok-
ing though you are aware of how badly it affects you. A specialist nurse is visit-
ing you to discuss smoking cessation.
TASK Tell the nurse that you have already reduced your smoking drastically
and that it would be impossible to quit completely
Tell her how stressed your days are with a busy work schedule and a
family of 3 children.
SETTING Hospital
NURSE You are specifically assigned the duty of advising those with long-term conditions on
smoking cessation and the effects this can have on their condition and treatment.
You are meeting a 42 year old woman admitted with an exacerbation of chronic pul-
monary disease. She leads a busy life, with an insurance job and a family of 3 chil-
dren.
PATIENT You are 42 year old male who has been admitted to hospital with gastritis. The
nurse is collecting information from you. You live in your own home with your
wife, who is 36 years old, and you have three teenage children living at home.
You have been drinking alcohol for 25 years and often suffer abdominal upset or
pain.
NURSE You are talking to a 42-year-old patient, a heavy drinker who has just been admitted
with gastritis.
TASK Find out about the patient’s general background: family, habits and general
health.
Respond to the patient’s questions about lowering his alcohol consumption.
Give advice in a positive and friendly way.
Role Player Card No. 29 NURSING
PATIENT The patient is your three year daughter Elizabeth. She is being admitted to hos-
pital for treatment of an ear abscess. This is the first time your child has been in
hospital and you are anxious about how she will manage. You can’t be at the
hospital all the time as you have two other children aged Joan aged 5 and Sam
aged 7. The nurse has requested information about your daughter’s normal rou-
tine at home.
NURSE Elizabeth, a three year old girl has come with her mother to be admitted with an ear
abscess. Her mother is anxious about how she will settle in. You need information
about the child’s normal routine and habits to prepare a nursing care plan.
TASK Reassure the mother about the care Elizabeth will receive.
Ask whether she has any siblings she usually plays with at home .
Ask about her normal routines at home
Usual bedtime – morning or afternoon sleep?
Food preferences – able to feed herself?
Is she fully toilet trained?
Has she brought any favourite toys or books with her?
Outline visiting hours – 11am – 8pm but stress that overnight stays are
possible in a special visiting room.
Role Player Card No. 30 NURSING
SETTING Hospital
PATIENT You are a patient who has recently undergone thyroid gland removal operation.
A head nurse has now come visited your room to examine you. You are very
anxious and you want to explain the problems you are facing after the operation.
NURSE You are a Head Nurse. You are attending on a patient who has undergone an opera-
tion for thyroid gland removal. The patient is unable to speak properly and she has
difficulty in swallowing or even breathing properly.
SETTING Hospital
PATIENT You are a patient who is recovering from a minor knee fracture. A nurse visits
you in the morning to deliver your breakfast. You want to know when you can get
discharge from the hospital as you are a student who has exams next month.
How you can recover from this knee fracture (time duration)
SETTING Hospital
NURSE You are delivering breakfast to a patient who is recovering from minor knee fracture.
The patient asks you of when he/she can be able to go home as he/she has exams
next month.
Suggest some easy exercises that will help bring some improvement in his /
her knee
Role Player Card No. 32 NURSING
PATIENT Your father is a resident at a nursing home and he recently had a stroke. He is
now being nasal tube fed. The staff use a lifting machine to transfer him. Many
things bother you and have come to the Nurse-in-charge to discuss your
father’s care.
TASK Tell the nurse that you think tube feeding is uncomfortable and that your
father might be finding it difficult.
Ask if there could be any other alternative to nasal tube feeding.
Show concern about the need for a lifting machine, and its safety.
Be worried about the patient’s privacy.
NURSE You are the nurse incharge and a resident had stroke, so now he is Nasal Tube
Fed, and uses lifting machine transfer. His son is visiting the patient and is has
concerns about the NTF, lifting machine and privacy.
TASK You have to assure the son that these are the best things possible at the
moment for his father
Explain NTF
- tube feeding prevents chocking
- nutritional requirements)
Explain why you use lifting machine.
- the machine is quiet safe,
- mproves blood circulation
- easy to transfer from bed to chair, and transfer to shower
Explain privacy issues
-curtains are drawn and the door is shut
Role Player Card No. 33 NURSING
PATIENT You are a 45 year old married woman with 3 children and a pretty stressful full
time job. Recently you have developed some rather unpleasant stomach pains
and your doctor has recommended a gastroscopy and a barium meal to see
what is going on. You have never had any suchtest before and are terrified that
you may have cancer as your grandmother died of ‘some stomach trouble’
though you don’t know exactly what it was.
NURSE Your 45 year old patient has come to the hospital for investigation of abdominal pain
which began a few weeks ago. She is extremely nervous about the tests and afraid
that she may have cancer
Explain some of the tests to the patients, (gastroscopy, barium meal etc.)
PATIENT You are a 40-year-old primary school teacher, also a mother of 6 children, your
students give you a nickname: Mrs Rainy because you always wet your trousers,
which is caused by pressure-induced incontinence, and your husband is not
interested in having intimate physical contact with you because you have trouble
holding your urine and you have used the bathroom every 10 minutes, but each
time you cant void all the urine.
NURSE A 40 year old woman who is suffering from some urinary problems demands you to
get a urologist to prescribe some anti-infalmmatory medications, but she feels shy to
disclose in words what she has been exerpiencing, she is worried about being scoffed
at.
TASK Find out what problems exactly the patient has without being unfriendly or
impolite
Reassure her and tell her of the possible causes and treatment available.
Role Player Card No. 35 NURSING
PATIENT You are a 32 year old bi-polar patient on some anti-maniac medication,
however you did not take them regularly
TASK Explain the following reasons for you not taking the medication:
- Sometimes you feel better, so you stop taking this drug...
- Other times, this drug makes you feel tired and drowsy...
- There are also times when you give your pill to another patient in the
family...
- Have taken it for 5 days already with no improvement, so you wonder
how long it takes to work
You are worried about how to deal with side effects.
NURSE Your 32 year old patient was diagnosed with bi-polar disorder, when conducting a
therapy session, you find out that the patient is not complying with medication
regimen.
PATIENT You are a the parent of a young boy aged 4 who was admitted through the
Children's Emergency Department for acute meningoencephalitis as a result of
a complication following mumps. He has fully recovered and is ready to be dis-
charged home. You are unaware that a vaccine is available in Australia which
protects against mumps. You would like further information and guidance re-
garding vaccinations. You also have a 2 year old son and have only lived in
Australia 6 months. You are concerned because some people say that vaccina-
tions are dangerous.
NURSE A young boy aged 4, was admitted to hospital through the Children's Emergency
Department for acute meningoencephalitis as a result of a complication following
mumps. He has fully recovered and is ready to be discharged home. His parents are
unaware that a vaccine is available in Australia which protects against mumps. They
would like further information and guidance regarding vaccination for Mumps. They
also have a 2 year old son and have only lived in Australia 6 months.
TASK Explain to the parent that the boy has fully recovered.
Make him/her aware of the importance of a full vaccination program for both
children.
Tell them what vaccination is required for mumps and when to have it.
Inform about the risks and benefits of the vaccination for mumps.
Explain any side effects that might occur from the vaccination.
Tell them that vaccination is a requirement of many schools.
Tell them that vaccinations can be obtained from free health clinics.
Role Player Card No. 37 NURSING
PATIENT You are Joseph Groom, a male patient aged 23. You were in the city drinking
with your friends and became involved in a fight and were knocked uncon-
scious. You hurt your head, hand and shoulder and woke up on the pavement.
Due to your injuries, you have decided to visit the A & E centre to get some
pain relief. You are having trouble getting your thoughts together but you just
want some pain medication so you can go home and “sleep it off”.
NURSE You are an A & E nurse. A man has presented at A & E at 3am. He states his name is
Joseph Groom. He has suffered a head injury and may have mild concussion. He
also has cuts and bruises to his body, his right hand is swollen and his clothes are
torn. He is intoxicated. He insists he wants something for pain relief while waiting to
see the doctor.
PATIENT You are a busy 50-year-old waitress, recently diagnosed with Type 2 diabetes.
You had a wedge resection 12 days ago and have post-operative infection in
your right large toe. You are resting at home and the district nurse is visiting to
change your dressing.
TASK Admit that you should have followed the surgeon’s advice, but did not,
so now you have an infection.
Argue that you need a quick fix to the toe because you need to get
back to work, the antibiotics obviously aren’t working.
Agree to use the nurse’s list of suggestions and accept that you did not
cause your own infection.
Tell the nurse that you know the risk that diabetics experience with
circulation, but would like a brochure on how to manage your illness.
NURSE Your patient is a busy 50-year-old waitress, recently diagnosed with Type 2 diabetes.
The patient had a wedge resection 12 days ago and has post-operative staphylo-
coccus aureus (staph infection, non-MRSA) on the right large toe. You are visiting the
home to change the dressing whilst the patient is resting from work duties.
TASK Find out about the patient’s general dialy habits after the operation. Did the
patient rest adequately?
Highlight the fact that sometimes people get post operative infection but it is
not really their fault.
Persuade your client to be patient and that the toe will heal with attendance
to dressings, fresh air and daily exposure to the sun, antibiotics, etc.
Explain the risk of circulation problems for diabetes and sometimes greater
risk of infection.
Supply a patient information brochure to the patient and agree to call again
next week.
Role Player Card No. 39 NURSING
PATIENT You are Harry Jones aged 78. You are a bachelor who lives on his own. You
were admitted to hospital to have a large lesion removed from your back. You
know you’ll be discharged in the next few days but meantime you want to
make the most of the rest and the hospital food. You want the nursing staff to
leave you in peace but a nurse says its time to get up and have a shower.
You are feeling quite cranky.
TASK Point out that you will be home in a few days and there will be plenty of
time to shower then.
Explain that at your age you need rest not exercise.
Argue that a shower will only wet the dressing on your shoulder.
NURSE Your patient, Harry Jones aged 78, is in hospital after surgery to remove a large
lesion from his back. He is recovering well and you want him to get up and walk about
and to have a shower. You have observed that he has neglected his personal hygiene
and appearance.
TASK Encourage the patient to have a shower, wash his hair and generally get
cleaned up. Be tactful as he can be quite cranky if he doesn’t want to do
something.
Say you will place a waterproof dressing over the lesion area.
Stress the importance of exercise and good hygiene in ensuring a speedy
recovery.
Role Player Card No. 40 NURSING
PATIENT Your father was scheduled for surgery at 10 this morning but due to some
reason he has not been taken to the operating theatre eventhough it is already
11 am. You have been upset seeing your father’s long wait. A nurse has just
come to talk to you.
NURSE You have been called to the patient's bedside. The patient was supposed to go in for
his surgery at 10 am and was second on the list but surgery was delayed because
the previous patient had some complications during surgery. Apparently he had never
had an anesthesic before and was suffering from post op vomiting, hadn't passed
urine and is in pain. The patient's daughter is very angry and wants to talk to you.
NURSE You are the nurse who works at the Gastroenterology Clinic. You see patients after
they undergo tests at the clinic. You are now talking to Jenny Vassily, a 25 year-old
who has been diagnosed with Irritable Bowel Syndrome at the clinic. The patient is
not sure about the conditions and needs advice about treatment and management.
TASK Find out about the symptoms she experiences eg. type, duration, frequency,
pain.
Find out about any triggers she may have noticed - e.g. stress
Explain what IBS is in simple language - no clear cause but intestines
probably over sensitive at times, smooth muscle becomes over active -
spasms, cramps, IBS - either constipation, diarrhoea or both
Outline treatment options - pt has been supplied with medication for pain,
diarrhoea and constipation. She needs to make diet changes (avoid high
fibre foods and gas-producing foods like cabbage, eat regular meals).
Stress management - suggest activities like yoga, meditation or gentle walks.
Role Player Card No. 42 NURSING
PATIENT Yesterday at work, you had a fit and you fell over. Your eyes were rolling and you
can’t remember what happened. (Your colleagues told you what happened
afterwards)
TASK Tell the nurse how terrified you are of having epilepsy
Deny the fact that you could possibly have epilepsy
Have an emotional reaction to the problem. Be hard to get through to.
NURSE The patient was recently involved in a car accident and suffered cuncussion.
TASK Get details of the current problem; the patient seems to have seizure at
work.
Listen with empathy and pacify the patient.
Discuss the possible causes of the seizure (brain damage etc), the test
required (an EEG) and the range of treatment available (medication)
Role Player Card No. 43 NURSING
PATIENT You are Richard Gibson, a grade 9 student at Hastings Secondary School. Your
teacher has asked you to see the visiting school nurse as he thinks that you have
put on more weight recently. You have been experiencing lethargy and has been
inatentive in class.
TASK Tell the nurse about your tiredness and difficulty in being attentive
Ask her for advice on reducing weight
Be unwilling to reduce fast food because that’s what you enjoy eating
Agree reluctantly to consume fruit and veggies
Agree to monitor your weight and see the nurse again after a month
NURSE You are the visiting school nurse at Hastings Secondary School. You are seeing
Richard Gibson, a grade 9 student who is obese. He does not participate in any
physical activities at school or at home and consumes fast food and sugary bever-
ages a lot. He feels sleepy while attending classes.
PATIENT Your doctor has referred you to the community health nurse for advice about
lifestyle changes, as your blood pressure is high. You know that you haven’t been
paying much attention to your health recently buy you have a stressed job as a
lawyer and your busy schedule makes it difficult for you to exercise on a regular
basis. You also smoke a packet of cigarette a day and enjoy a couple of drinks
after work; although you know this isn’t good for you, it helps you to cope with the
stress of work.
TASK Answer the nurse’s questions about your lifestyle honestly, but be a bit
defensive in your replies.
NURSE The client has high blood pressure and has been referred to you for advice on lifestyle
changes aimed at reducing it. The medical report indicates that the client smokes,
drinks and does not take any regular exercise. He/she has a stressful job as a lawyer.
TASK Question the client about his/her smoking, drinking and exercise habits.
Suggest ways in which your client can modify his/her lifestyle to improve his/
her health.
Be sympathetic to your client’s reasons for being reluctant to change his/her
habits but insist that at least some changes are necessary for the sake of
his/her health.
Role Player Card No. 45 NURSING
PATIENT You are Doris Mack aged 80. You have woken up following hip replacement surgery
and are having trouble getting your thoughts together. Keep asking for your daughter
and say you need a cup of tea as your mouth is dry.
Don’t pay any attention to what the nurse is saying - keep asking for your
daughter
NURSE You are a nurse in an operating theatre recovery room. 80-year-old Doris Mack is
recovering after hip replacement surgery. She is receiving IV fluids. She has been
able to tell you her name but seems confused about where she is. She keeps
asking to see her daughter and to have a cup of tea.