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The basic hospital chain of command, however, remains unchanged. In British hospitals, for example, it is the consultant - a doctor-whose name appears on patients’ notes and who carries ultimate responsibility. Next in line is the registrar, then senior house officer, and then house officer. In the UK, primary care (the first contact with the medical team) is often provided by general practitioners, who are doctors working out in the community, and by nurses called health visitors.
When it comes to recovery care and corrective treatment, other members of the team with special expertise come into the picture. These are professionals such as physiotherapists, occupational therapists, and speech therapists. Because barriers are breaking down between ancient and modern views of illness, many hospitals now encourage interaction with complementary medicine, so it is now common for acupuncturists and masseurs to have a part to play too.
Hospitals also employ dentists, pharmacists, opticians, laboratory technicians, receptionists, and administrative staff. The whole structure is kept going by the ancillary staff-the porters, cleaners, and kitchen staff who, in their turn are supported by volunteers - an important force of individuals whose contribution to the effectiveness of a hospital is often underestimated.
|1. scrub nurse||/ˈskrʌb nɜːs/||y tá phòng mổ|
|2. cardiologist||/ˌkɑːdiˈɒlədʒɪst/||bác sĩ tim mạch|
|3. receptionist||/rɪˈsepʃənɪst/||nhân viên lễ tân|
|4. surgeon||/ˈsɜːdʒən/||bác sĩ khoa ngoại|
|5. physiotherapist||/ˌfɪziəʊˈθerəpɪst/||chuyên gia vật lý trị liệu|
|6. radiologist||/ˌreɪdiˈɒlədʒɪst/||bác sĩ X quang|
|7. consultant||/kənˈsʌltənt/||bác sĩ tham vấn|
|8. anaesthetist||/əˈniːsθətɪst/||bác sĩ gây mê|
|9. paediatrician||/ˌpiːdiəˈtrɪʃn/||bác sĩ (chuyên khoa) nhi|
|10. porter||/ˈpɔːtə(r)/||nhân viên bốc vác|
Dialogue 1: P=paramedic, B=Mrs Benson
P: Can you hear me? Mrs. Benson?
B: Yes. Where am I? What happened?
P: You are in my ambulance. You’ve had a fall and we are taking you to hospital.
B: Yes. Now I remember.
Dialogue 2: R=radiologist, B=Mrs Benson
R: Right, Mrs. Benson. We’re going to have a closer look at your heart. Have you had an x-ray before?
B: Yes. I broke my leg once.
Dialogue 3: S=sister, B=Mrs Benson
S: Hello Mrs Benson. How do you feel?
B: Terrible. I’ve got a terrible headache and I need to use the toilet.
S: Ok. I’ll draw the curtains and you can use a bedpan. Doctor Bright is coming to have a look at you in a moment.
Dialogue 4: C=consultant, B=Mrs Benson
C: Mrs. Benson. We’ve been worried about you but I’ve got good news. The x-ray shows your heart is clear and Sister says your blood pressure is back to normal. How are you feeling?
B: I feel fine now.
C: Good. I am going to prescribe some medicine and I’m discharging you.
Dialogue 5: R=receptionist, B=Mrs Benson
R: Right, Mrs. Benson. So you want to make an outpatients appointment for next week?
B: Yes, please.
R: Thursday at four?
R: Good. Next Thursday at four o’clock to see Doctor Lee in Outpatients.
A job interview
I = Interviewer, R = Rachel
I: Ok Rachel, let’s start the interview with a few questions. Your CV says that you are working at City Hospital.
R: Yes, in the operating theatre.
I: Are you a fully-qualified scrub nurse?
R: Not yet. At the moment I’m doing a part-time course and working at the same time. I’m preparing for the exams, which are next month. It’s hard, especially when I am working a night shift and going to lectures next day.
I: Tell us about your job. What do you do every day?
R: Well, I assist the surgeons. I prepare the instruments for surgery and I help with the operations.
I: What do you like best about being a scrub nurse?
R: I like watching operations, but it’s the contact with the patients that is most rewarding.
I: So, why are you applying for a new job?
R: Well, I’m very happy in my job, but I want more responsibility.
In Britain, every nurse is on a grade. The grade depends on experience and skills, and each grade has different responsibilities and pay. On the bottom grades are unqualified auxiliary nurses who do the routine work on hospital wards. On the top grades are nursing officers, who are usually administrators.
Auxiliary nurses are on the bottom grades, but student nurses get the lowest pay. However, students don’t stay at the bottom of the pay scale forever. When they qualify, they start working on a middle grade. As they get experience, they can get promotion and move up the ranks to become staff nurse, then sister (charge nurse if a man), and perhaps eventually nursing officer.
Many nurses work shifts, and often they work overtime to earn more money. After basic training, many nurses choose to do further study and become specialists. Nurses can specialize in many different fields – there are triage nurses working in Casualty, and psychiatric nurses who treat the mentality ill. There are breath visitors who visit patients in their own homes, practice nurses working in GPs’ surgeries, and midwives who deliver babies.
Many of them say they do not get enough pay and respect for the work they do. They say that the work is physically and mentally hard, that they work long hours and get very tired. But they also say that there are many great rewards which have nothing to do with money.
Pet power In recent years, more and more hospitals have found that pet visits can help to calm, reassure, and motivate patients. Studies show that petting animals can reduce anxiety, lower blood pressure, and help patients to heal faster, Patients are sometimes happier to see their pets than they are to see people their dog doesn't care if they smell funny or look terrible.
Impressive results Lea Ann Matura, an advanced practice nurse at the Methodist Hospital in Houston, remembers the time a pet visited her owner, a woman with lung cancer. "This patient hardly ever woke up or spoke. She never got out of bed and she rarely ate anything, says Matura, but after a visit from her dog, she sat up, looked happier, and started talking. She was a different person. Not all results are as impressive as Matura's, but pet visits can make a difference. When 31 pet visits were observed at The Hospital for Sick Children in Toronto, Canada, researchers found that pet visits helped to improve patient and parent allowed on the paediatric ward at Sutter Medical Center in children have a California. "Many strong connection to their pets, explains Amy Medovoy, child life programme co-ordinator. "If the pets can visit them on the ward, we can bring the child's normal everyday life into the hospital, and we this helps the child to heal better.
Breaking down barriers
People may be concerned that pets will transmit diseases to patients, but hospitals report that they have had no cases of patients being infected by animals. Some hospital staff may feel that pet visiting is not a good idea. Lea Ann Matura comments, I thought the doctors wouldn't agree, but all of our doctors think it's a good idea. However, it is important to have a clear policy and a list of rules or guidelines before pets are allowed to visit. It can take a lot of time and effort to make sure that the programme is successful