第3章 Reception and Patient Admissions
Tim had been running a high fever since last night，so his dad Mr.Wood took him to the hospital to find out the reason for the continued problem.At the waiting room，Mr.Wood said，"Could you tell me when the doctor is coming？I have been waiting here for one hour and you said the doctor would come soon."The nurse answered，"I am sure there is some emergency and the doctor is held up.I will go and check for you and let you know when he will come.I am sorry you have had to wait for so long."Tim said，"No，I don't want to see the doctor，I am scared."
Warm-up Questions
1.How to react to a patient who has been waiting for a long time？
2.What information do you need to collect if you are admitting a patient？
3.What strategies can you use to put a pediatric patient at ease？
Dialogues
1.Admitting a Patient to the Ward
(Nurse Tracy is admitting a senior patient.She inquires the patient about his basic information，medical history and allergy.)
Section 1：Greeting a Patient and Self-introduction
Nurse：(looking the patient in the eye)Good morning，I'm Tracy.I am responsible for admitting you to the ward.Could you please come into the patient admission office，so I can get your paperwork done？
Patient：Good morning.My name is John Smith.Of course，I would like to sit down.
Nurse：You can take this chair here.(supporting the patient to the seat)You can put your cane on the edge of the chair if you like.(helping the patient put down his cane carefully)
Patient：Thanks.
Nurse：How are you doing today？
Patient：Not too bad，thank you.I haven't been waiting for too long at all.
Nurse：That's good.Now，I'm going to take down some details.I'd like to ask you a few questions，is that all right？
Patient：Of course.That's fine.
Section 2：Collecting and Checking a Patient's Information
Nurse：All right，let me just get the admission form.
Patient：OK.Thank you.
Nurse：(sitting at eye level with the patient)OK，let's get started.Is it OK with you if I check out some details first？
Patient：Sure.
Nurse：(smiling)I'd just like to check your name and date of birth to see if your ID bracelet is right.Would you please tell me your full name and date of birth？
Patient：Yes，it's John Smith and my date of birth is July 7th，1945.
Nurse：Can you tell me why you are here today？
Patient：Hmm，I've got high blood pressure 1，and I'm here for some tests.My doctor asks me to check my blood pressure regularly.
Section 3：Inquiring about Medical History
Nurse：Well，now I'd like to know your medical history.Have you had any serious illnesses in the past？
Patient：Em，ten months ago，I had a headache and a palpitation.Moreover，I felt dizzy sometimes.It really scared me.
Nurse：(leaning towards the patient and nodding)Yes，I'm sure it was scary.How about history of surgeries？
Patient：No，I'm very lucky.I never have.
Nurse：(smiling)That's great.Now are you taking any medication？
Patient：Yes，after my heart attack，my doctor asked me to take some blood pressure tablets.
Nurse：Could you show them to me，please？
Patient：Yes，here they are.I took them in the morning before breakfast.
Nurse：Right.In order to lower your blood pressure，you are taking metoprolol.
Section 4：Inquiring about Allergy
Nurse：Do you have any allergy to any medication？
Patient：Not that I know of.
Nurse：How about food allergies？
Patient：Oh，no.
Section 5：Inquiring about the Next of Kin
Nurse：Very good.Could you tell me the name of your next of kin 2？
Patient：It's my son，Jeremy Smith.
Nurse：(smiling)Thank you.I will leave you here for a moment while I get the doctor to come and see you.
Patient：Thanks.
2.Admitting a Pediatric Patient
(Nurse Kathy is admitting a pediatric patient.She inquires the patient about his basic information.)
Section 1：Greeting a Pediatric Patient's Parents
Nurse：Excuse me，Mr.Wood，I'm Kathy，the nurse on duty today.How can I help you？
Father：Oh.My son was running a high fever last night.I am here to see what's going on.He is scared of anything related to hospitals.
Nurse：Please do not worry.I will try to comfort him.
Father：OK.
Section 2：Communicating with a Pediatric Patient
Nurse：(walking to Tim and kneeling in front of him)Hello，Tim.I'm Kathy.How are you today？
Child：I'm feeling a little bit dizzy，but I don't want to be injected.It is very painful.
Nurse：Tim，do you have a lot of friends？
Child：Yes，they all like playing with me and they say I'm very nice.(very proud)
Nurse：That's great！So，you must be a gentleman，Tim，because gentlemen are very friendly to others.
Child：Yes，I think I am.
Nurse：Now，I also want to be your friend，can I？
Child：Of course.
Nurse：(smiling)Thank you.I'd like to get to know you.Can you tell me something about yourself？
Child：Of course.
Section 3：Collecting a Patient's Information
Nurse：Tim，can you tell me your full name and when you were born？
Child：All right.My name is Tim Wood.I was born on May 2nd，2004.
Nurse：Good，have you been seriously sick before？
Child：I had my appendix out when I was 8.Since then，I have been scared of anything related to hospitals.
Nurse：(nodding)Sorry to hear that，Tim.Since we are friends，I will try to help you feel less afraid during your treatment.(patting his shoulder)So are you taking any medication now？
Child：No.
Nurse：Are there any food or medicine that you are allergic to？
Child：Nothing like that.
Section 4：Giving some Encouragements
Nurse：OK，great.You've done great，Tim.Now can you wait for me for a while and play with your dad？
Child：OK.
3.Receiving a Patient Who has been Waiting for a Long Time
(Mrs.Chad has been waiting for two hours and she turns a little angry.Nurse Shona makes apology to her and admits her.)
Section 1：Greeting a Patient and Responding to Complaints
Nurse：Good morning，Mrs.Chad.My name is Shona.I am responsible for reception today.I'm so sorry to have kept you waiting for such a long time.There was an emergency just now.
Patient：Yes，it has indeed been a long time to wait.I have been here since 8 this morning，and it's 10 already.You said my doctor would come at 8：30.
Nurse：(smiling)I am sorry for the inconvenience.I will go and check with the doctor.He gave emergency treatment to a patient who fainted just now.It's an unexpected condition.I would let you know when he comes as soon as possible.
Patient：Oh，fine.
Nurse：(smiling)OK.Thank you for being so understanding.
Section 2：Collecting a Patient's Personal Information
Nurse：Let's get started.Would you mind if I check out some details first？
Patient：OK.What would you like to know？
Nurse：Could you tell me your full name and date of birth？
Patient：My name is Jane Green Chad and my date of birth is May 5th，1967.
Nurse：All right.Can you tell me what your problem is？
Patient：Well，I've got a severe pain in my left leg，and I'm here for some tests.My doctor wants to see the results.
Section 3：Inquiring about Medical History
Nurse：OK.Now I'd like to ask you about your medical history.Have you had any serious illnesses in the past？
Patient：Yes，I had a pneumonia last year.And my joints of hand have been aching from February this year.
Nurse：(leaning towards the patient and nodding)Yes.Now what about past surgical procedures？Have you ever had any operation？
Patient：No，I never have.
Nurse：(smiling)That's great.Now are you taking any medication at this time？
Patient：Yes，my doctor puts me on some aspirin for my arthritis.
Nurse：Right.
Section 4：Inquiring about Allergy
Nurse：Do you have any allergy to any other medication？
Patient：Not that I know of.
Nurse：What about food allergies？Any food you are allergic to？
Patient：Yes，I'm allergic to nut.
Nurse：Which kind of nut？
Patient：Peanut.
Nurse：Which type of reaction do you have when you eat it？
Patient：It makes me hard to breathe.
Section 5：Inquiring about the Next of Kin
Nurse：All right.Can you tell me the name of your next of kin？
Patient：It's my daughter，Mary Green.
Nurse：(smiling)Thank you.That's all I need.Thank you for your cooperation.I will leave you here for a moment while I get the doctor to come and see you.
Patient：Yes，thanks.Please don't make me wait for so long again.
Nurse：Of course，I'll do my best.
Notes
1.high blood pressure高血压=hypertension
【拓展】常见症状
headache头痛
fever发烧
vomiting呕吐
chest pain胸痛
itching瘙痒
diarrhea腹泻
broken bones骨折
abdominal pain腹痛
sore throat咽痛
nosebleed流鼻血
pressure in the chest胸闷
breathless气短
rash皮疹
sprain扭伤
cuts/lacerations裂伤
2.next of kin近亲
【拓展】询问信息
name名字
DOB(date of birth)出生日期
address地址
nationality国籍
medical insurance医疗保险
Communication Strategies
I.When you are admitting a patient，how can you put him/her at ease？
Tip 1：Sit at eye level with the patient.This helps patients feel that you are interested in talking to them rather than over them.
Tip 2：Make positive responses whilst nodding your head.This encourages patients in their attempts at learning new information.
Tip 3：Don't make judgmental comments.This shows respect for the patients and their rights to make decisions about healthcare.
Tip 4：Use humor to establish a good rapport with your patient.This can lighten the atmosphere and help the patient relax.
II.When you are admitting a child，how can you put him/her at ease？
Tip 1：Use small talk，for example asking about the child's hobbies or interests.
Tip 2：Involve the child in decision-making and give encouragements.
Tip 3：Use short，simple phrases which they can understand.Use a calm and cheerful tone of voice.Explain medical terminology in simple terms.
Tip 4：Use simple and clear sentences and check for understanding.Use pictures and diagrams to illustrate what you are saying.
III.What are active listening strategies？
It is especially useful when you are dealing with complaints using active listening strategies.Active listening strategies are used to put the other person at ease，show interest in what is being said，and confirm understanding of what has been said.Some of the strategies are as follows：
Tip 1：Use expressions such as"Really？"，"Is that right？"，"I see"and"yes"or"no".
Tip 2：Make"listening noises"like"mm"or"hmm"，which shows that you are interested in what the speaker is saying.
Tip 3：Gesture or use body positions like leaning towards the other person and nodding to show interest.
Tip 4：Smile while maintaining eye contact，which helps put a patient at ease.
Useful Patterns
Admitting a patient…
1.I'd just like to check your name and date of birth to see if your ID bracelet is correct.Can you tell me your full name and date of birth，please？
2.Can you tell me why you are here today？
3.Can you tell me what is wrong with you？
4.I'd like to ask you about your medical history.Have you had any serious illness the past？
5.What about history of surgeries？Have you ever had any operation？
6.Are you taking any medication at this time？
7.Do you have any allergy to any medication？
8.What about food allergies？Any food you are allergic to？
Communicating with a child…
1.That's great！So，you must be a gentleman because gentlemen are very friendly to others.
2.I also want to be your friend，can I？
3.We'd like to get to know you.Can you tell me something about yourself？
4.Since we are friends now，I will try to help you feel less afraid during your treatment.And you are a man now，a gentleman！You're great.
Responding to complaints…
1.I'm so sorry to have kept you waiting for such a long time.There was an emergency just now.
2.I am sorry for the inconvenience.I will go and check with the doctor and I am sure he was held up.I would let you know when he comes as soon as possible.
3.Thank you for being so understanding.
Role Play
Lily and her mother go to see the doctor because Lily has been vomiting since this morning.But it is Sunday and they have to wait for a long time.The doctor hasn't come and Lily is starting to complain.Please make a dialogue among Lily，her mother and the nurse on duty.