Interpersonal Relationships (Final 5-7) Flashcards
What is another name for a patient’s health care record?
chart
What are the contents of a patient’s health care record?
- medical history
- daily progress (filled by nurses and physicians)
- vital sign records
- fluid balance sheets
- lab reports
- reports by allied health professionals
What form of records are usually on your patient’s chart that are filled out by health care aides?
- Kardex
- Fluid Balance Record
- Activity of Daily Living (ADLs) flow sheets
True or false? A patient’s health care record or chart is a legal document and must have basic guidelines and legal standards.
True.
Identify 5 general charting guidelines.
- understand reason why you are documenting (read carefully)
- check for right patient, right room and right chart
- include date and time with each entry (24 hour clock)
- chart entries in chronological order
- chart changes as patient’s condition changes
- be brief, factual and objective
- record only what you observed or have done
- use a pen, write clearly, spell correctly, proper medical terminology,
- no blank spaces or lines between entries
- sign each entry with signature and job title
- make corrections with line through mistake, write error, put initials
- use appropriate abbreviations
- stamp each form with client’s name and other info
- never chart procedure or treatment until after completion
- do not omit info
Meaning of: Hemiplegia
hemi=half
plegia=paralysis
Meaning of: Dyspnea
dys=difficult
pnea=breathing
Meaning of: Bronchoscopy
broncho=bronchi
scopy=examination using a scope
Meaning of: Laryngitis
laryng=larynx
itis=inflammation
Meaning of: Leukocyte
leuko-white
cyte-cell
Meaning of: Ophthalmoscope
ophthalm=eye
scope=examination instrument
Meaning of: Tachycardia
tachy=fast
cardia=heart
Meaning of: Glucometer
gluco=glucose
meter=measuring instrument
Meaning of: Mammogram
mammo=breast
gram=record
Meaning of: Splenectomy
splen=spleen
ectomy=removal of
Meaning of: Aphasia
a=lack of/not/without
phasia=speaking
Meaning of: Arthralgia
arthr=joint
algia=pain
Meaning of: Psychosis
psych=mind
osis=condition
Meaning of: Pyrrhea
py=pus
rrhea=discharge
Abbreviation of: hour
h
Abbreviation of: activities of daily living
ADL
Where would you find the abbreviations used by the facility you work for?
policy manual
Meaning of: abd
abdomen
Meaning of: ac
before meals
Meaning of: ad lib
as desired
Meaning of: a.m.
morning
Meaning of: as tol
as tolerated
Meaning of: bid
twice a day
Meaning of: BM (bm)
bowel movement
Meaning of: BP
blood pressure
Meaning of: BRP
bathroom privileges
Meaning of: oC
degrees celsius
Meaning of: CA
cancer
Meaning of: cath
catheter
Meaning of: CHF
congestive heart failure
Meaning of: c/o
complains of
Meaning of: COPD
chronic obstructive pulmonary disease
Meaning of: CPR
cardiopulmonary resuscitation
Meaning of: CVA
cerebral vascular accident (stroke)
Meaning of: DAT
diet as tolerated
Meaning of: DNR
do not resuscitate
Meaning of: drsg
dressing
Meaning of: dx
diagnosis
Meaning of: EKG
electrocardiogram
Meaning of: FF
force fluids
Meaning of: hs
bedtime
Meaning of: ICU
intensive care unit
Meaning of: I&O
intake and output
Meaning of: IV
intravenous
Meaning of: MI
myocardial infarction
Meaning of: NPO
nothing by mouth
Meaning of: NWB
non-weight bearing
Meaning of: O2
oxygen
Meaning of: OR
operating room
Meaning of: OTC
over the counter
Meaning of: pc
after meals
Meaning of: p.m.
afternoon/evening
Meaning of: prn
when necessary
Meaning of: PT
physiotherapy
Meaning of: qhs
every night at bedtime
Meaning of: qid
four times a day
Meaning of: ROM
range of motion
Meaning of: stat
at once / immediately
Meaning of: SOB
shortness of breath
Meaning of: tid
three times a day
Meaning of: TPR
temperature, pulse, respiration
Meaning of: ↑
increase
Meaning of: ↓
decrease
Meaning of: +
positive
Meaning of: -
negative
Meaning of: š
without
Meaning of: č
with
Meaning of: Ǿ
no, nil
Meaning of: Δ
change
Which laws protect the confidentiality of patients?
- Freedom of Information and Protection of Privacy Act (FIPPA)
- Personal Health Information Act (PHIA)
As a health care aide, what are you legally obliged to do with a client’s information?
Obliged to keep all written and verbal information about a patient’s care, treatment and condition confidential.
Who can you not discuss with about your patients.
- patient’s relatives, friends, visitors (refer all questions to nurse)
- other patients
- fellow workers
- news media
- own family and friends
True or false. Patients do not have the right to access all information about their condition and treatment, and can’t see their chart.
False. The responsibility to give out this information is for the physician.
True or false. Anyone can have access to the computer codes to view a patient’s information.
False. Never give an unauthorized person these codes
Define a group
Two or more people who interact over time and share common needs and goals.
Why is it better as a group?
- help people achieve goals that would be unattainable by individual effort alone
- strength from combining knowledge, efforts and creativity
True or false. No one health care worker can meet all of a patient’s needs alone.
True. Require input from all to deliver optimal care to patients.
Define a team
Special kind of group brought together for a specific purpose and characterized by complementary talents of its various members.
What is the main goal of the health care team?
providing optimal care for each patient
Name the advantages of working in groups or teams.
- provide access to greater range of resources
- promote problem solving abilities
- encourage greater risk-taking
- peer support
- economical and cost-effective
- positive and trusting atmosphere
- flexibility
- opportunities for communication and collaboration
Name the disadvantages of working in groups or teams.
- time consuming
- different opinions
- different values
- other commitments
- different beliefs
- talking over each other
- power issues
Name the two types of groups that are classified based on structure and type of interaction.
- Primary Group: small intimate group where relationships are personal, spontaneous, cooperative and inclusive
ex) family, friends - Secondary Group: larger more impersonal group
ex) professional associates, task groups, political parties
Name and give an example for each type of group found in the health care setting.
- Task group: focus is completion of specific task ex) patient care conference
- Teaching group: provide information to participants ex) parenting class
- Self-help groups: small group of volunteering individuals who share a similar problem ex) Alcoholics anonymous
- Therapy group: work towards self-understanding and changing behaviours
What are therapeutic groups?
their focus is on helping others
ex) teaching group, self-help group, therapy group
Name the key ingredients of a therapeutic relationship.
- mutual trust
- respect and acceptance
- caring
- therapeutic communication techniques
How can a group be effective?
formal leadership: unit manager or school principal
less formal and temporary: nurse becoming leader for specific condition in patient
Name the three stages of group development.
- initiation stage
- working stage
- termination stage
What are the characteristics for the initiation stage?
- members get acquainted
- identify problems and goals
- roles are given
- dependency on leader
- restricted communication
What are the characteristics for the working stage?
- members work together
- assimilation of attitudes and beliefs
- control and power issues
What are the characteristics for termination stage?
- summarize accomplishments
- review unmet goals
- evaluate group experience
- prepare for separation
Name the three major group roles.
- task roles
- maintenance roles
- self-serving roles
What are the characteristics of task roles?
- focus on the tasks of the group that enhances and coordinates the group’s movement toward achievement of goals
ex) starter
ex) information and opinion giver
What are the characteristics of maintenance roles?
- focus on creating and maintaining climate of cohesion and stability to emphasize progress and minimize conflict
ex) encourager
ex) tension reliever
What are the characteristics of self-serving roles?
- aim to satisfy individual needs, does not enhance group effectiveness (an obstacle)
ex) aggressor
ex) self-confessor
Distinguish between effective and ineffective group functioning: Atmosphere
- informal, comfortable, relaxed
- tense and boredom
Distinguish between effective and ineffective group functioning: Goal setting
- goals, tasks and objectives clarified
- unclear and misunderstood
Distinguish between effective and ineffective group functioning: Leadership and member participation
- shifts from time to time based on knowledge and experience
- delegated and based on authority
Distinguish between effective and ineffective group functioning: Communication
- open and two way, ideas and feelings encouraged
- closed or one way, feelings ignored
Distinguish between effective and ineffective group functioning: Decision making
- by consensus
- by highest authority with minimal involvement of members
Distinguish between effective and ineffective group functioning: Cohesion
- inclusion, trust, liking and support
- ignored or used to control members
Distinguish between effective and ineffective group functioning: Conflict tolerance
- high tolerance and reasons for disagreement examined
- low tolerance and ignored, denied, avoided
Distinguish between effective and ineffective group functioning: Power
- determined by members’ abilities, power shared
- determined by position in group, obedience is strong
Distinguish between effective and ineffective group functioning: Problem solving ability
- high, frequent constructive criticism
- low, destructive criticism
Distinguish between effective and ineffective group functioning: Self evaluation as a group
- frequent, all members participate
- minimal, done by highest authority
Distinguish between effective and ineffective group functioning: Creativity
- encouraged
- discouraged, people are afraid
Identify the steps when searching for and obtaining a job.
- self-appraisal
- searching for employment
- preparing a resume
- applying for a specific job
- participating in an interview
- deciding to take the job or not
What is the self-appraisal step?
-determine personal assets and limitations that will impact the choice of employment
(What does and employer want?)
Which assets should you consider when at the self-appraisal step?
- kind of patients you want to work with
- special skills you have
- caring attitude
Which limitations should you consider when at the self-appraisal step?
- home responsibilities
- hours you can work
- transportation
- child care issues
Name the three employability skills groups from the National Business and Education Centre of Canada and Conference Board of Canada. Give examples in each group.
1) fundamental skills ex) communication, manage information, use numbers, thinking and solving problems
2) personal management skills ex) demonstrate positive attitudes and behaviours, responsibility, adaptability, learning, working safely
3) teamwork skills ex) working with others, participation
Where are common work places for health care aides?
- personal care homes
- geriatric centers
- long-term care facilities
- acute care facilities
- government-run home care companies
- private home care companies
- hospitals
- clinics
What is a resume?
-written summary of your education and work history and accomplishments
Name the two different styles of resumes.
chronological and functional
What should you include in your resume?
- personal information (name, address, phone number, email)
- educational background (name of school, certificates, diplomas, degrees)
- work experience (job title, name of employer, length, brief description of tasks)
- other information (volunteer work, languages, training, workshops)
- references (three, 2 for work skills and 1 personal reference, name, title, phone number)
How should a resume be written?
- simple writing style
- don’t cram
- be brief
- use action verbs
- correct spelling and grammar
- 8 1/2” X 11” paper
What should you do when filling an application form?
- read the whole application first
- use a good pen
- be neat
- complete, honest and accurate
- correct spelling
- complete entire form
Why is it important to make a good impression on the application form?
-Even though it is repetition of your resume, it is convenient for employer in the screening process. The information and format is the same for all applicants, making it a lot faster for employers.
How should you prepare for the interview?
- know strengths and skills
- learn about facility
- practice interview questions
- know how to get there and how long it takes
- know interviewer’s name and position
- dress conservatively
- take extra copy of resume
- make list of questions to ask interviewer
How should you dress for an interview?
- clean hair
- brush teeth
- not too much makeup
- little jewellery
- no perfume or cologne
- trimmed nails
- avoid revealing clothing
What questions to not ask interviewer?
-salary, benefits, hours and vacation time
On the day of the interview, when should you arrive?
15 minutes before
What should you do during the interview?
- firm handshake
- stand until invited to sit
- let interviewer guide conversation
- friendly, courteous, positive
- smile
- make eye contact from time to time
- avoid one-word answers
Which questions can the interviewer not ask you?
ethnic background, age, marital status, personal finances, religious affiliations
What should you do at the end of an interview?
- thank interviewer
- leave resume
- write short thank you note