English for Health and Behavioural Sciences

Universitat de les Illes BalearsSchool of Nursing

UNIT 1 Patient admissions

On the session of the 8th October, we looked at the following topics:

First of all, the teacher reviewed how "the wiki" works and then solved some problems a few students had when accessing it. Then, he explained the most important sections of the wiki followed by the procedure to mark the written assignments that we shall carry out through the course.

Then, we also saw a motivational video entitled “marcianitos” located in the page "my sandbox". The content of this video is about pursuing our aim and not giving up under any circumstances if we really wish to attain our objectives.

After that, we focused on unit 1. The teacher showed us the section “English for nursing, unit 1: Patient admissions" all of its contents: the glossary, the objectives, the abbreviations, the anatomy of the heart and the hyperlinks located in the page "useful web links”.

Next, the teacher also explained the vocabulary and the new handover tool, which is like a diary on what has been dealt with each session. The handover is a new tool from Google drive, and anyone can access it (with a permission by the editor, similarly to the wiki) as long as we provide a gmail account. It can be used as a personal portfolio where we can find, among others, all the words with their corresponding meaning that we have previously studied.

To end the class session, we looked at the first activity of the unit 1 paragraph c and we were told to do the following activities:● Explain in our own words how the heart functions.

● Become familiarized with the abbreviations document.

● Write our personal "handover" with a vocabulary section.

Vocabulary section of unit 1

● Personal portfolio● Gauze● Take shifts - turn taking● Over - the - counter● Next of kin● Rely on= trust● Ward ICU● Collect = gather● Greet● jot down● living will

On the session of the 15th October, we looked at the following topics:First of all, we read the handover from the previous session. As we were reading the writing, the teacher explained again to us how the wiki and the Handover worked in order to update it for the new students who have joined the course.

Then, we saw Unit 1. The teacher showed us some very interesting hyperlinks located on page "Useful Web Links" which are "English for nursing, Unit 1: Patient admissions". Inside them you will find the following hyperlinks:● Clinical Knowledge Summaries: is a source of evidence-based

information and practical "know how" of the common conditions in primary care. For example: you go into topics and click allergies and you will see all kinds of allergies there.

● Living Will (Advance Directive): you learn the advantages of an advance directive, the limitations, how to manage and develop them and who should make them.

● Advice and information about the consent form.● Heart animations and interactives.

After that, the teacher explained again how to access the Handover tool by means of our gmail account. When we enter our gmail, at the top there is a section that says Drive. Click and it will take you directly to the Handover.

Next, we dedicated about half an hour to talk about the different variety of errors that we made in the compositions handed in for our first assignment.i.e. spelling, accuracy, coherence, cohesion and grammar.

If we have any doubts, we will be able to solve them on the following session as the teacher has offered to answer questions (grammatical...). We will have around 10 minutes to solve any kind of doubts.

After that, we focused on Unit 1 of the course book "Cambridge English for Nursing". We did exercises 1g, 2a, 3a and 3b.The script we followed was:● How to admit patients with: we learnt formal questions to ask

to elderly patients e.g.: Would you mind if....? or Could you please…?. The language we use with young patient and finally the approach we should have with a patient who has been waiting for a long time.

● Active listening strategies: They show interest in what is being said and confirm the understanding of what has been said. The most important strategies are: eye contact, social ability, nodding, gestures and body language.

● How the heart works.

For our information the next day we will end unit 1 and we will begin unit 2. Also, we shall need the book to continue the class.

The assignment for the forthcoming session is:1. Explain in our own words how the heart functions (it will be a

performance)2. Exercise 2e. You make a short admission form following the

pattern. You have to write the questions (your choice) and their answers. It is an individual task and the deadline is on Friday 19th. Also, the next day in class we will role-play it.

I found very useful vocabulary:

● Complain, approach, aid, assist her/him, straight language, anxiety, empathise, apologise for the delay, reassure, active listening, eye contact, nodding, social ability, body language, gestures, personal space, put somebody at ease, key (e.g. what is the key to...? make up = invent, leaflet,

● The heart○ Systole / diastolic ○ Shortness of breath○ Cardiac cycle○ Heartbeat○ Blood

● Flow, atrium (singular) / atria (plural), valves (tricuspid valve), ventricles, pulmonary / lungs, blood vessels: vein or artery, aorta, chambers, pump, oxygenated / de-oxygenated / re-oxygenated, t-shaped, tissue, muscles, healthy, illness = sickness, perform = carry out, stick, life threatening, care, prescription, Encase in, thicker, entire, let in = coming, fill, shut, backflow, blockages, lead, in order to, disease

On the session of the 22nd of October, we saw the following topics:First and foremost, we took a look at the handover that was read by Inés. The teacher explained to us that, from now on, the handover will be a collaborative work between two classmates, who will be in charge of explaining what has been seen in the previous class. Moreover, all the students are welcome to edit, correct or make any suggestions on the handover. In other words, it will be a joined intellectual effort that gathers and mixes anything each one of us has absorbed and retained.

On the other hand, the teacher showed us how he gathered all the vocabulary studied up to now, and, by using a web tool, he creates a heart-shape form with all the words.The amazing thing about this is that, by clicking on anyone of these words, it leads you directly to a web page that shows the definition of the word chosen. You can also hear how it is pronounced.

The teacher also informed us that we will have to prepare a portfolio which contains everything we have learned: assignments performed, role-playings, or any other material that has served us to learn. This portfolio will be delivered at the end of this course and will be rated.Portfolio: is used to plan, organize and document education, work samples and skills. Career portfolios serve as proof of one's skills, abilities, and potential in the future.It should include: personal information, evaluations, sample work, awards and acknowledgments.

Right after that, we saw a video on Youtube, whose message spreads a very important rule about how to learn English. The rule says: "learn complete phrases rather than individual words". In other words, vocabulary is best retained if it is studied with words that fit in phrases with specific meaning and context. It is a new way of learning English and sounds very efficient. If you are interested in the video click here.

Next , we used, once again, the "Assignment number 1 " to correct all types of errors. We can highlight the followings:

● "Get on very well with someone" instead of "have a good relationship" cuando hablamos de persona que no son la pareja.

● REMEMBER: the personal pronoun "I" always goes in CAPITAL LETTER. Never in lower case letter.

● In English we say: "To choose from ..." but not "to choose between... ".

● Don´t use the preposition "with" after "to get married". Instead we use "get married to" or "be married to".

● Be careful! Use punctuation. Don't abuse of using "and, and, and...."

We have seen another Youtube video called "What I've learned" and we were asked to respond some questions. The video deals with how a nurse is taking pride in nursing. Afterwards, we saw another video:

How does the heart work? Then, two classmates explained to us how the heart works in their own words.

The blood enters the right atrium passing through the tricuspid valve to the right ventricle. Then, the blood continues its way through the pulmonary artery to be reoxygenated in the lungs.The reoxygenated blood goes back into the heart through the pulmonary vein.

After that, the blood enters into the left ventricle. It´s here where the oxygenated blood is pumped around the body via the aorta. These valves open to let in sufficient blood flow to fill each heart chamber and then shut to prevent the backflow of blood.

Finally, we will use the rule nº 1 mentioned above for the vocabulary section: ● We can leave whenever you're ready = at whatever

time you're ready. ● I get on well with all the members of this class = I'm in

harmonious term with them. ● Humility is one of the virtues of a nurse = being modest

is a virtue. ● You may meet sticking patients at the hospital but you

still have to care about them = Even if the patients are very demanding or it is hard to deal with them you should keep great patience and take care of them.

● She took great pride in her sons = She felt very proud of them.

● Older people feel alone when their children leave home = they feel lonely.

● I only regret, in my childhood, the opportunities that I didn't embrace = I didn't take up certain occasions willingly.

The assignment for the forthcoming session is:

1. From the book (Professional English in Use), we must do: unit one, two and three; the teacher said that he would put this book on the wiki.

2. The teacher has put on wiki a few extra pages that we have to check, so that, if we have any doubts, we will be able to solve them the next day.

On the session of the 29th October, we saw the following topics: First of all, we read the last handover which was written by our classmates, Asma and Jennifer. We reviewed it to check if it was well done and complete.Later, the teacher explained to us that he will send an e- mail to everybody with an opinion poll, where we can write our suggestions and make comments about the subject. It will be anonymous and individual.

We continued reading “ A nursing handover” in the page 11 and after we discussed about three questions;

● Why could handovers be problematic?● Why is it important to be clear and concise

when giving a handover?● Why are effective comunication skills important?

The exercises that we did during the session were:

1. Exercise D, in page 11 → We had to connect the abbreviations to their meanings

2. Exercise F, in page 12 → First, we did a listening and we had to complete a text with all the words

3. Exercise D, in page 13 → We practiced how you would say the blood pressure readings

4. Exercise B, in page 13 → We listened to a conversation and we had to complete some questions

5. Exercise 5H, in pages 86 and 93 → We practiced on a patient record form in an oral exercise

At this point, we finished Unit 1.

After that, we started unit 2 which is about Respiratory problems: Asthma. The teacher mentioned the points of the unit that we will be studying in the next sessions. These points are:

● Educating patients about asthma management● Giving Instructions effectively● Using a nebuliser● Talking to a child about asthma● Putting a young patient at ease● Describing respiration● Charting respiratory rates

Next, we saw two videos about asthma. The first video was about a doctor who explained what asthma illness is. The second video explained what happens in the lungs when someone has an asthmatic attack.

To finish the class, the teacher told us important vocabulary of the first three units from the Professional English in Use book.Unit 1: What is your general health like? How’s your health, generally? Get over = to recover Get better = to improve Get worse = to deteriorate

Unit 2 and 3: We have to know the anatomical terms, but common words also for when the patients arrive to the hospital so we can understand them and help them.For example: Anatomical term Common word Abdomen Stomach Axilla Armpit Carpus Wrist Coxa Hip Cubitus Elbow Patella Kneecap Small bowel Small intestine Large bowel Large intestine

Unit 3: The pelvis: Bladder Right kidney and left kidney, Ureter Urethra The chest: Airways, Bronchioles Windpipe The assignment for the forthcoming session is:From the Professional English in Use book, we must do: Unit four, five, six and seven

I found very useful vocabulary: UNIT 1Go in-depthBriefed- informedRestless nightNursing jargonControl nursing wardBP: blood pressureqds: four times a dayMI: myocardial infarction, or heart attackGTN: glyceryl trinitrate; also called nitrolingualSHO: senior house officer

4º: four hourly, or every four hours; also 4/24c/o: complain ofsl: sublingual, or under the tongueO2: oxygenECG: electrocardiogramADLs: activities of daily livingPt: PatientObs.: Observations

UNIT 2Suffer from Prevention Diminish-reduce Breath Breathe Take breath in/out inhale/exhale InfectionVirus- virusesBacteria Exposed toWheeze- Breathing out

WheezingImpaired abilityTest- TrialDiagnosedCoughTriggersDustFurAsthma (mild, moderate, severe)WindpipeAirway

NarrowedSwellRelapseDevice

On the session of the 5th November, we dealt with the following topics:

First of all, we read the last handover which was written by our classmates, Sheila and Raquel. We checked it and corrected some mistakes.Later, the teacher reminded us that we must answer and send opinion poll, where we can write our suggestions and make comments about the subject as soon as possible

Then we were reminded about the importance of correct pronunciation by the teacher.Example:● pronunciation of -ed forms (/d/ or /id/)● Past Simple of read it pronounced /red/

Plan of the today's lesson:

● Educating patients about asthma management.● Using nebulizers.● Respiratory problems.● Use of English: Passive Voice.

Next we did a warming up activity, we discussed about three questions:1. What types of respiratory problems are you

familiar with?2. Have you cared for a patient with respiratory

problems?3. What factors might aggravate a respiratory

condition?

During the class we did the following exercises:

● Listening: How to use a peak flow meter. After that we did the exercise 1B of page 14.

● With the same listening we realised the next exercise (1C) that consist in get missing information.

● Exercise 1D in page 15: we had to place the sentences in correct order.

● Then we did together the activity 2B about giving instructions effectively.

● After that we discussed in pairs the following questions:a. What is your experience of asthma management?b. What kind of asthma treatment is available?

● Listening: How to use a nebulizer for the first time.er the listeAftning we did the exercise 3B that consists of putting several steps in the correct order.Next in the exercise 3C we completed instructions matching the beginnings to the endings.

● At the end of the class, we listened to a conversation between a nurse and a child talking about asthma and completed the exercise 4A.

Passive Voice: main steps in English

In passive voice we don't want to inform about the agent who carried out the action as such. In fact, we don't need to say who did the action.The main rule:Write the verb To Be in the same tense as the main verb, and the main verb in the 3º form if it's an irregular verb or by adding -ed if it's a regular verb.The direct object became the subject and the original subject doesn't appear.

Examples:Somebody built this house in 1935.This house was built in 1935.

Somebody cleaned this room yesterday.This room was cleaned yesterday.

They told me the information.The information was told to me.I was told the information.

Important advices given by our teacher:

We should use polite expressions when we talk to our patients: would you mind if...?; I'd like you to+infinitive...; could you...?

When we give instructions we must use a this sequence: 1. First of all2. Next3. After that4. The last thing to remember

The language we use is very important when we talk to patients, it must be approachable and polite so that we can put them at ease.

Pronunciation focus

During the class we practice our pronunciationExamples:Larynx LaryngealPharynxPharingeal

The assignment for the forthcoming session is:

From the Professional English in Use book, we must do: Units 8, 9 and 10.Practice Passive Voice.

Useful Vocabulary

We found some useful vocabulary:ObesityDrugsPollutionHand-deviceHoovering/vacuuming(vacuum cleaner)At easeNasal cavityOral cavity

Voice box or larynxBronchusAlveoli Throat or pharynxepiglottis tracheapleural membraneintercostal placewindpipeDyspnoeapneumonia

TuberculoseAirway infectionsinvasive ventilationrelief from painkeep an eye on something

On the session of 12th November we saw the following topics:First of all, we read the last handover that was done by Paulina and Victor. We reviewed it and checked it.Before starting with the lesson, the teacher exposed us three topics to discuss at class.First: The date of the first partial exam will be on 3rd December (written exam)

Including Unit I and II of English for nursing, and the first ten lessons of Professional English in use.

Second: The percentage of the oral test will be 30% of the final score. The date will be in February but we don't have a date yet.

Third: Extra classes on February before the oral exam date. Two sessions of two hours each on February 1st and 4th. Additionally, will be held a seminary of 4,5 hours.

After that, we returned with some passive voice theory and a few exercises prepared by the teacher:

About the passive Voice:

PRESENT: VERB TO BE (AM, IS , ARE) + VERB –ED/ 3RD FORM OF IRREGULAR VERBI´m afraid I can't do it= I'm afraid it can't be done

PAST: VERB TO BE (WAS/WERE) + VERB –ED/3RD FORM OF IRREGULAR VERBThe thief took all my CD´s= All my CDs were taken by the thief

PRESENT CONTINUOUS: VERB TO BE + BEING + VERB –ED/ 3RD FORM OF IRREGULAR VERB

Someone is building a new house= A new house is being builtFUTURE: WILL BE + VERB –ED/ 3RD FORM OF IRREGULAR VERB

They will hold the World Cup in Brazil in 2014= The World Cup Will be held in Brazil in 2014

PRESENT PERFECT: HAVE or HAS BEEN + VERB –ED/ 3RD FORM OF IRREGULAR VERB

Someone has written a book about alien visits Europe= A book has been written about alien visits Europe

Right after that, we continued with Professional English in Use book.We started with Unit 4: Functions of the body

We discussed the 5 senses: Sight, smell, taste, hearing and touch (also called sensations or feeling)To ask about senses we use these questions:

- What is your…..like?- Is your…. Normal?

Doctors talk about NUMBNESS when there is a loss of sensation

Other functions of the body are:Function Verb NounSpeaking Speak Speech

Walking Walk Gait

Breathing Inhale (breathe in) Breath

Respiration Exhale (breathe out) Breath

Urination Urinate Urine

Micturition Pass urine / pass water

Defecation Defecate Faeces Pass faeces /pass stools Stools

Menstruation Menstruate Period/ Monthly Have a period

When taking a history, nurses can ask:Do you have any (trouble, difficulty,

problems) + function or verb?

We practiced with our classmates these questions on page 17 exercise “Over to you”:

Do you have any trouble with your appetite?Do you have any trouble passing water?Do you have any problems with your speech?Do you have any problems breathing?

Other expressions commons in English are:When did you last…When did you first…

We finished the Unit 4 doing all the exercises on page 17.

We started Unit 5: Medical Practitioners 1

In this unit the teacher explained to us the two main branches of medicine:

Surgery; the doctors are called Surgeons (Male are addressed as Mr., and female as Ms.)

Internal medicine; the doctors are called Physicians (are addressed as Dr.)

Specialties:

Names of specialties usually end in –ology; names of the specialist usually end in –ologistIf the specialties ends in –ics; names of specialist usually ends in –ician

There are some exceptions: anaesthetics and anaesthetist

E.g. Cardiology – CardiologistPediatrics- Pediatrician

When we talk about specialist, we say they are good with or good at, also we can say they are interested in, worse with or specialize in.

Good with + somethingGood at + verb-ing

E.g.: Good with people Good at dealing with illness

If you need to ask about the specialty you can use this question:

What does a _________ specializes in?What does a dermatologist specializes in?

We made the four exercises on page 19 and finished unit 5 with the last exercise “Over to you”What qualities do you need to be good at to be nurse?

Good at listeningGood at taking care of patientsGood with empathyGood at taking quick decisions

In the last 30 minutes of the class we returned to the English for nursing book. We listened again to the conversation of the exercise 2.4 and we made the exercise 4C and 5B.

Homework:Do the exercise 5E on page 18. In pairs use the diagram of healthy airways and asthmatic airways on page 17 to explain what happens in an asthma attack. Student A is a nurse and student B is a patient.Practice this dialogue between them because we are going to represent this conversation in class with a classmate.

Additional VocabularyUnit 4:To toddleToddlersBlushSweatSwallowNoticeOvercomeGet overRecover StoolsGait

Unit 5:Appeal

Tying of

NHS – National health service

General Medical Council

Graduate

Pregnant woman or pregnancy

Small talk

Decision-making

Session of 19th NovemberAt first time, we revised and checked the previous handover. Then, we watched a segment which was the beginning of the film Girl Interrupted, a film released in 1999 and made by James Mangold. We would have liked watching a little more of the movie but we had to practice the expressions: “THERE IS “, “THERE ARE” and its past tenses. We practiced talking with our classmates checking the items which would be, in our opinion, in the psychiatric institution showed in the film. For example: Do you think there is any art-room in the hospital of the film? (Remember it´s an indirect question and the verb does not change the order).

While we were doing this exercise a new expression very useful in the nurse offices appeared. That´s “TO HANG OUT” which means to spend time doing nothing, just chatting, having a coffee or just doing nothing special.After that, we were thinking about an ideal hospital using the modal verb SHOULD+BE to make an advice or opinion. For example: “In our opinion, in a utopic world, an excellent hospital should be warmer and cozier because the people who live there are in narrow circumstances and need be surrounded by beauty and tranquility. For instance, in our ideal hospital should be private rooms, wifi and a recreation area with a garden.”

Later we took the book Professional English in Use and we did the unit 6: Medical Practitioners. To know who is who in hospital we almost need to study a Master much more difficult than study the medical career!The person in charge of or the manager of the hospital is called Medical or Clinical Director. He or She is the chief of the medical staff.In the UK after the university degree in medicine you are Qualified, then you have to do the Foundation Programme that lasts two years.The person who is doing the Foundation Year 1 or 2 is called generally Junior Doctor. But if we want to talk more properly we must use Foundation Year 1 Doctor (FY1), and Foundation Year 2 Doctor (FY2). There are two expressions which are not commonly used nowadays: Pre Registration House Officer (PRHO) or House Officer, which is equivalent to FY1 Doctor, and Senior House Officer to refer FY2 Doctor.

After these two years they finish the training and they become General Practitioners. They have the option of studying a specialty (this is volunteer). When a doctor has finished specialties he/she becomes Consultant. While they are studying specialties they are called Registrar or Specialties Registrar.There is a junior doctor IN CHARGE OF/RESPONSIBLE FOR taking the Medical History of the patient. The action of taking the medical history is TO CLERK., ex. the Junior doctor clerks the patient. The registrar together with the junior doctor decides the treatment or what to do next. For example: X-ray, ECG, etc.Later, the impatient (a patient who is staying at hospital) receives the visit of Consultant, who does Ward Rounds together with a team of junior doctors plus nurses.

Sometimes doctors go home but they are still on duty, the expression used for that is to be on call. That´s means that the doctor could be at home but he/she is localized over radio pager or bleeper.The staff of the hospital usually works taking shifts. That’s means that they work on a rota basis.After we have learned this new vocabulary we completed the exercise number 6.4.Then we went to Lesson 7 to learn the vocabulary associated to the nursing profession.Nurse working in hospitals are divided in different grades.Student Nurse is the nurse who is still in training.When the nurse finishes her/his studies becomes Staff Nurse.The Charge Nurse is in charge of ward, she is also called Sister. She/He is not the superior. The superior is the Manager, also called Matron.There are three kinds of support workers such as: Clinical Support Worker (only with vocational studies), Auxiliary (unqualified, not university studies) and Ward Clerks. The ward clerk is in charge of updating, that means put the dates in correct order, answering the phones and so on.

Like doctors there are specializations for nursing job in the UK:

Midwife is a nurse who specializes in pregnancy and childbirth.District Nurses visit patients in their homes.Health Visitors work in preventional education area, prevention of illness and vaccinating and education programs.

Then we talk about the specialization in Spain. We identified six specializations: psychiatric, geriatric, midwifery, surgical instrumentation and labour nursing.Two important verbs in nursing job are TO CARRY OUT and TO PERFORM. Both have the same meaning. It´s more appropriate using these verbs in the passive tense.Examples:

The procedure was carried out instead of someone carried out the procedure.The test was performed.Then we did the exercise 7.1, 7.3 and 7.4 of the Professional English in Use with different tenses of the terms to carry out and to perform.

At the end of the session we received good news about the next exam in December. The units included in the exams will be from unit 1 to 7 of Professional English in Use book, and unit 1 to 2 of English For nursing.Later we did exercise 6.a, 6.e and 6.d of the book English for Nursing.

VOCABULARY

To hang outWard roundRota basisTo clerkAnd so onImpatientDischargedOn dutyOn callPCA: patient control analgesia

S.C: subcutaneousR.C.: register nurseOT: Operation TheatreVaccineTo vaccinateTo carry outTo performAppears to beSeems to beUpdatingThe suffix –less: means without. For example: pennyless, homeless, and breathless.

Session of 3rd December

We started this session watching ''Charlie and the Chocolate Factory'', a 2005 American film directed by Tim Burton.The plot is about a candy producer that announces a contest where the children that find golden tickets in chocolate bars will be given a full tour of the factory and a chance to win a great prize.Our task was to identify some misbehavioural patterns in two of the characters, Augustus and Veruca.

The definition of misbehaviour is a person who behaves badly or in an inappropriate way.

Veruca Augustus

Spoiled bossy Demanding greedy Arrogant = snobbish quite compulsive Capricious unhealthy Authoritarian selfish Ungrateful

After that, we saw how to advise someone's conduct using modal verbs like should, might and could. For example: “you could be more easy going” and “you should be more patient...” Then, we also learnt how to make suggestions using sentences as “why don't you try to…”, “let’s …” and “shall we…” We also read and corrected the last handover.

BonesLater, the teacher explained to us unit 16: Bones

We saw some common and anatomical names for bones: skull (cranium), jaw bone (mandible), spine (vertebral column), breastbone (sternum), rib (costa), collarbone (clavicle), shoulder blade (scapula), thigh bone (femur), knee cap (patella) and shinbone (tibia).

A fracture is a break in a bone and there are 5 different types:-Greenstick: It's an incomplete fracture in which the bone is bent. This type occurs most often in children.-Displaced: It happens when broken bone pieces are not aligned.-Comminuted: It's a fracture in which the bone fragments into several pieces.-Impacted: It`s one whose ends are driven into each other.-Open (compound): It's an injury where a broken bone is open through the skin.

We also saw the treatment of fractures. Treatment consists in promoting bone union by reducing the fracture. After reduction, excessive movement of the broken bone is prevented by fixation, which can be external (for example a splint or plaster of Paris cast) or internal (for example a pin or a plate and screws).Later, we completed the exercises 16.1, 16.2 and 16.3. Additional vocabulary:ReduceUniteMalunionExcruciating = extremely painful

Oncology

In addition, we saw Unit 28: Oncology. The teacher explained us about neoplasms and the differences between them; benign ones do not spread and are less harmful, and malignant ones spread throughout the body causing serious illness or death.Growth or tumour, are common terms usually used by doctors when informing patients. A lump or swelling is a collection of tissue or fluid visible and palpable, indicating a possible neoplasm, although there are other causes.

When a tumour invades local tissues or spreads to distal parts of the body, it receives the name of metastasis. The results of metastasis are called secondary neoplasms (opposed to the original tumour which is the primary). We also saw some examples of symptoms and signs of malignancy, as pain and weight loss (anorexia).

The treatments of tumours consist in removing or excising them by surgery and also radiotherapy or chemotherapy. When a cure is not possible, the patient receives palliative treatment (to resolve symptoms).

Then, we completed exercises 28.1, 28.2 and 28.3

Table of exercise 28.1

After that, we discussed about a "lymphoma" in groups.

Verb Noun(s) Adjective(s)

cure cure curative

excise excision excised

grow growth growing

invade invasion, invasiveness invasive

obstruct obstruction obstructive

palliate palliation palliative

palpate palpation palpable

spread spread spreading

swell swelling swelling, swollen

Lymphoma It's a neoplasm produced by excessive growth of lymphocytes, cells that form part of the body's immune system.Normally is presented as a solid tumor and treatment may involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type and stage of the disease. It's also a related ''opportunistic disease'' in HIV patients.

Therapies

We concluded the class studying unit 42 where we saw different types of therapies:Radiotherapy is the use of controlled radiation doses to treat cancers.Chemotherapy is a treatment with anti-cancer drugs.Physical therapy is a remediation of disabilitiesand the promotion of mobility, quality of life and movement carried out by physiotherapists (also known as physical therapists).

Cognitive Behavioural Therapy is used to treat mental health disabilities. It can be conducted as a face-to-face session between patient and therapist or provided by computer.

Additional vocabulary:Adjuvant StrontiumGrays Hip replacementDaily dose (fraction) ManipulationRadioactive MassageImplants CrutchesNeedles

Finally, the teacher told us to do exercises 42.1, 42.2 and 42.3 at home.

Session of 10th December

We started this session with the exam about units 1 and 2 to Cambridge English for Nursing and units 1 still 7 to Professional English in Use.

The exam was in two parts. Firstly we started the exam with grammar and vocabulary activities, then we did the listening part.

The second part to the session was dedicated to learn the modal verbs.Why they call modal verbs?They are called modal verbs because are auxiliary verbs. They are used to indicate modality.We saw differents kinds:-Permission: can, may.-Obligation: must, have to ( is semi modal verb)-Predictions: Be going to, future simple with will..-Advice o suggestions: should, could...-Prohibition: Can´t , musn´t...-Ability: Can, Be able to, could

What are Modal Verbs?Modal Verbs are special verbs which behave very differently from normal verbs. Here are some important differences.1º. Modal verbs do not take "-s" in the 3rd person.e.g: He can speak Chinese.

She should be here by 9:00.2º. You use "not" to make modal verbs negative, even in Simple Present and Simple Past.e.g: He should not be late.

They might not come to the party

3º. Many modal verbs cannot be used in the past tenses or the future tenses.e.g: He will can go with us.

I will can speak english.This two sentences are not correct. We have to say:Will be able to speak english.

4º. They never take do/does/didException: With "have to" as it is a Semimodal: Does she have to go?

After that we focused in predictions.When making predictions ( what we think we´ll happen in the future) we can either use:-BE GOING TO + VERBBe going to is used to predict future events that are very near ( and can be seen ) or seem sure to happen. Such predictions are based on present evidence:e.g: Look at the clouds; It´s going to rain.-FUTURE SIMPLE WITH WILLThe future simple is used to made predictions that are based on personal judgement, opinion or intuition, and not on present evidence.

Whether or not the event will happen is not certain. Such predictions are often introduced by I think / I don't think.e.g: I don't think he'll come tonight.In the first person SHALL can be used instead of WILL in formal contexts:e.g: Whatever happens, we shall always be best friends.The future simple is also used to make general predictions about facts that are always true or events that always happen.e.g: A gentleman will hold the door for a lady.

-MODALS IN FIRST CONDITIONALMain clause:Instead of will we can use other modals in the main clause of the first conditional:e.g : If you don´t watch your steps, you are going to fall over. (prediction)The last thing that we saw in class was one video " In the love and loss", about brain atrophy, was a really touching video. After that, we had to made some questions about video and we changed the questions with the rest of classmate for give answers to them. We had to send this answer to teacher Wednesday.

Additional vocabulary:-vanish: something that dies away, is consumed,extinct.-Touching-Handle: I can handle it / I'm able to manage the situation

On the session of the 7th of January, at the beginning of the class, the teacher explained how to use the Google Drive, to hang all the tasks that we send.

To do this go into google drive click on "create", choose the document you want to use, write the task and share it with whoever you want, write his/her email address. Also we can decide what that person can do with our document, edit, comment or just read.

Then, our colleagues Edurne and Luis, read their handover. The teacher made some corrections. For example, explained when to use the ending-ing.

After that, the teacher showed us the phrases made by ourselves and correct them together.He emphasized the need to improve our English. As New Year's resolutions, the professor recommended studying modals verbs and the conditional sentences.

Then, we did an exercise that consisted in writing two predictions about the video you would see then. We only knew the title of the video, "Life Interrupted. Love in the Time of Cancer ".After watching the video, we discussed our predictions, to check if they were correct or not.

After that, we started unit 30 of Professional English in Use, The respiratory system. We studied aspects such as coughing and auscultation, and how to communicate with patients to ask about these parameters.

Then we did an overview of items 47, 48 and 49, entitled Taking a history 1, Taking a history 2 and Taking a history 3, respectively.

Following this review, the teacher explained to us what the oral test will be like. We should do a little research before oral representation. It should contain the following sections: introduction, research, results and conclusion. To do this, the professor recommended us revising the units 55, 56, 57, 58 and 59 of the book Professional English in Use.Moreover, the teacher gave us some recommendations. Like for example, change the language on the menu on the TV or tune in radio channels in English. In addition, the management gave us a very interesting website "englishcentral.com".

To end the last class of the year, we were surprised by John Lennon’s Christmas video clip to wish us Merry Christmas and Happy New Year.

New vocabulary:Fear, frightened, exchanged, bone marrow transplant, side effects, get through, care for somebody, take care of..., look after somebody, cough, auscultation, stetouscope, crackles, sputum, phlegm, loose (productive), dry (non productive), blackout, dizzy, fits, blurred, prickles, to feel prichly, onset.

On the session of the 14th January, we looked at the following topics:First of all, we read the handover from the previous session. The teacher explained us the differences between make/do, this/that and which/what.- Make: We use the verb make for constructing, building or creating.- Do: We use the verb do when someone performs an action, activity or task.- This: It is used to indicate something that is near.- That: It is used for something that is distant.- Which: we use “which” in a question that requires a choice between two or more items.- What: we use “what” when we are not asking for a possibility.

Then, we decided the dates of the seminars: February the 1st for the first 11 students, following the order of the list, and for the rest of the list, the 4th of February. The seminars will last 4 hours (16h-20h). In these seminars, we will prepare the oral presentation. The date of the written exam is on the 7th of February at five o'clock and the oral exam on the 8th of February at four o'clock. Beware! The 3rd year Students have the exam on January 28th.After that, we saw a video entitled “Killed for organs: China's secret state. Transplant Business”, based in forced donations in that country. We did a brainstorming and then we did a diagram that explains the most important points of the video. The teacher told us that it was a good way to expose the topic of our oral presentation. Following this scheme, the oral presentation will consist of:1. An individual presentation explaining the topic chosen for 5-7 minutes.2. An interaction on a common situation with a partner, for example, giving advice to a diabetic patient.

Next, we focused on Unit 41 and 34 of the course book "Professional English in Use".- Unit 41: Surgical treatment. We saw common vocabulary of surgical specialization: site (operating theatre),

clothes (gowns, masks and gloves), the most basic instruments: retractor, scalpel, artery forceps, dissecting forceps and scissors, the actions common, and an operation report. We should do the exercises on page 91 at home.

- Unit 34: Basic investigations. In this unit we saw useful instruments, like for example: the ones used in ophthalmoscopy or for measuring blood pressure (for example, a sphygmomanometer and a stethoscope).

We have also seen the things that the phlebotomist needs during vein puncture.Finally, we returned to the Unit 3 of "Cambridge English for Nursing". We did exercises 1f, 2a, 2b, 2c, 3a, 3b.The script we followed was:- Asking for advice:

o Would you mind + verb –ing….?o What would you recommend to change these dressings?o What do you think I should do with this ulcer?o What do you suggest we can use?

- In small groups, we discussed some questions about our profession (Why are Clinical Nurse Specialists important members of the health team? What are the possible effects of chronic wounds on the patients?, What are the implications for the healthcare system?) and then we shared our ideas with the whole class.

- We learned an interesting vocabulary on exercise 3b.- To end the class, we did the exercise 3a. It was about how to describe the images that appear. Describing

images you should use: It looks..... I found very useful vocabulary:- Organ trafficking: to buy and sell transplantable organs or tissues illegally.- Organ donation program: A program that manages Organ donation.- Donors: someone who gives organ to be used in another person.- Business (noun): economical benefits.- Harvest: remove from a culture or a living or dead body, as for the purposes of transplantation. Forced organ

harvesting- Transplant (verb) / transplantation (noun): to move something, or to be moved, from one place or person to

another.- Overseas (adjective, adverb): foreign, out of country, beyond the sea.- Waiting time: The average waiting time for liver transplants in our hospital is one week.- Surgery: medical operation.- Operating theatre: a special room in which people are operated on in a hospital.

- Sterile conditions: free of or using methods to keep free of pathological microorganisms.- Scrub up (phrasal verb) = Disinfecting: Wash thoroughly.- Surgeon clothes = surgical gowns, masks and gloves.- Prepping: abbreviation of preparing.- Drape: a sterile covering arranged over a patient´s body during a medical examination or during surgery in

order to reduce the possibility of contamination.- Retractor: surgical instrument that holds back the edges of a surgical incision.- Scalpel: a very sharp knife used in surgery.- Forceps: a metal instrument with two handles used in medical operations for picking up, pulling and holding

things.- Scissors: a device used for cutting.- Operation: a medical procedure involving an incision with instruments.- Swab: a pad of cotton or other material used to soak up blood from the operation site.- Sucker: a mechanical device which to absorb.- Ligatures: thread used by surgeons to bind a vessel (as to constrict the flow of blood).- Diathermy: a method of therapy that involves physical or electrical therapeutic treatment.- Drain: tube inserted into a body cavity (as during surgery) to remove unwanted material.- Suture: surgical stitches which join together the edges of wounds.- Ophthalmoscopy /opthalmoscope: allows the doctor to examine all parts of the eye: the iris, lens, retina

and optic disc.- Sphygmomanometer: a pressure gauge for measuring blood pressure.- Stethoscope: is used to hear the sound of blood rushing back through the artery.- Systolic blood pressure (SBP): the first thumping sound.- Diastolic blood pressure (DBP): the thumping sound is no longer heard.- Veinpuncture: taking blood.- Phlebotomist: a nurse specialized in taking blood.

- Tourniquet: a tight band above the site.- Haematoma: a black and blue mark.- Bruise: it is a specific mark where the vein was punctured.- Bruising: can be used to describe a number of bruises or a larger area.- Heal: get better.- Pus: a fluid product of inflammation.- Sore: an open skin infection.- Uneven: a quality of uniformity and lack of variation.- Edges: border.- Yellowish: slightly yellow.- Blackened: go black, darken.- Dry: describes something that has no water or other liquid in, on, or around it.- Necrosis: death of cells and living tissue.- Eschar: thick, dry, black, necrotic tissue.- Desiccation: drying out.- Inflammation: swelling caused by infection.- Swab: a small piece of material which is used to take samples of body fluids.- Slough: dead tissue which separates from healthy tissue after infection.- Debridement: the removal of dead tissue.- Cellulitis: inflammation of the tissue under the skin, often caused by infection.- Ulcer (noun) / Ulcerous (adjective): an open sore on the surface of the skin or

a mucous membrane

On the session of the 21st January we saw the following topics:

First of all, we read the last handover which was written by Judith. We reviewed it to check if it was well done and complete.Later, the teacher gave us some questions about viruses and we had answer them (true or false).Then we watched a video on vaccination of influenza virus in the USA where two doctors from different states exposed the importance of immunization against this virus.After watching the video, in groups, we made a brief summary of four lines explaining the content of the video. Then we read some of these summaries.

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Next, we focused on unit 4, “Diabetes care”. The first thing that we did was to listen to a dialogue of exercise 4.1, which accounted for a conversation between a diabetes specialist nurse and her patient. Then, we did the exercises 4.1b and 4.1c

Then we saw an animation which very easily accounted for the differences between type I and type II diabetes.

Afterwards, the teacher explained to us both, where the screenplay would be downloaded and how to perform with the procedure for the evaluation of the oral examination of our classmates.

Finally, Judith took part in her oral examination, which was about the vaccination and vaccination calendar for children in our community. In order to complete this area, Mariángeles and Judit did a role-play about a dialogue between a nurse and a patient who turned up at the emergency ward.

On the final session of English for Health and Behavioural Sciences carried out on the 28th of January the teacher confirmed the date for both the written (February the 7th at 17h) and oral exam (Friday the 8th at 16h).Then, we watched a documentary on Facing Death about which several issues were raised. After that, we studied the introduction to unit 6 Medications.As for the final exam, from the book Professional English in Use we studied units 1 to 10, 14,16, 28, 30, 34, 41, 42, 47, 48, 49, 50 and 54 and the pages 143 to 145.Whereas in the English for Nursing book we looked at the units 1-4 and 6.