One day，Linda went to a hospital which is near her house.After talking with her doctor，she was required to have a gastroscopy.Her palms started sweating，then she nervously began to ask her doctor these questions，"This is my first time to have a gastroscopy.I feel tense.It is normal，right？"
"Is it painful？"
"It will be really painful，won't it？"
"Everything will be fine after having this test，right？"
"I feel stupid being so nervous.Am I bothering you，doctor？"
At that moment，her doctor said，"Now，I am going to give you an anesthetic injection in your mouth."
Warm-up Questions
1.What would you do to allay anxiety in a patient who'll have a test in a hospital？
2.You are giving a test to a patient who needs to take off her top in a room.How can you protect her privacy？
3.How can you help patients who are impatiently waiting for their tests stay calm？
Dialogues
1.Helping a Patient Relax before He/She Has Some Tests
Conversation 1：Having a Gastroscopy
Section 1：Listening to a Patient
(Before having a gastroscopy1，a patient is extremely nervous.As a duty nurse，Alva tries to listen to the patient to vent her anxiety.)
Nurse：Hello，I'm Alva.Nice to meet you.
Patient：Oh，hi，nice to meet you.Please call me Emma.
Nurse：So，Emma，is everything OK？
Patient：Everything's fine，but I'm just so nervous about tomorrow's gastroscopy.It will be really painful，won't it？I haven't been in a hospital since I was a child，when I broke my leg.Things have changed a lot in a hospital since then，right？
Nurse：Well，hospitals have changed a little bit.But don't worry，you can ask as many questions as you like.
Patient：Thanks，Alva.
Section 2：Comforting a Patient
(Alva tells the patient what she should do before she has the gastroscopy，because the patient may feel less anxious when she knows what to expect.)
Patient：Alva，I feel stupid being so worried.I'm not normally like this.
Nurse：(nodding and then leaning towards Emma)It's OK，Emma.It's quite normal to feel nervous.I'll try my best to let you know what you should do before you have the gastroscopy.People usually feel less anxious when they know what to expect.
Patient：Yes，you're right.It's very kind of you to tell me that.
Nurse：Actually，before you have the gastroscopy，you will be asked to take a kind of oral anesthetic 2 which will anesthetize your throat.Most people can endure it.Don't worry.
Patient：Oh，I see.Perhaps for the sake of my health，I have to endure it.
Nurse：That's right.
Section 3：Answering Specific Questions
(The patient has some questions to ask，and Alva answers them specifically，and then tells the patient what she can and cannot do.)
Nurse：Since you will have the test tomorrow morning，please eat a light dinner tonight.Moreover，the doctor has ordered that you have nothing by mouth from 10 p.m.until the test is finished.
Patient：Oh，sure，I get it.I feel much better now.
Nurse：I'm glad to hear that.Another question，Emma，do you have a history of any chronic disease 3 or allergy？
Patient：No.Oh，can I wear my dentures 4 tomorrow，Alva？
Nurse：I'm afraid not.You must remove your dentures before the test to prevent them from blocking your airway.
Patient：OK，Alva.
Section 4：Telling a Patient What to Do in the Test
(Alva tells the patient what she can do when having the gastroscopy，meanwhile she reminds the patient of preparing some food.)
Nurse：When the endoscope 5 is inserted into your throat，you're supposed to swallow，so that it will make the scope go into your esophagus 6 smoothly.If you feel sick，Emma，please exhale gently，then you'll feel better.
Patient：I'll remember that.Thank you，Alva.
Nurse：That's all right.Since you may get debility by fasting for a long while，please prepare some food，such as bread and eggs.
Patient：Yes.I believe it is necessary to do so.Thanks for your explanation，Alva.That's a relief.
Nurse：It's my pleasure，Emma.
Conversation 2：Having a CT Scan of the Abdomen
Section 1：Chatting with a Patient
(Before having a CT scan 7 of the abdomen 8，a woman is anxious.Nurse Lily has a small talk with the woman to put her at ease.)
Patient：Hi，Lily.I will have a CT scan of the abdomen next Monday morning.This is my first time to have a CT scan.When I think about it，my palms start sweating.
Nurse：Hello，Linda.I am very glad that you can share your feelings with me.It's completely normal for you to be tense.
Patient：Thanks，Lily.
Nurse：Now I'll tell you what you should pay attention to before you have this test.People always feel less nervous when they know what to do.
Patient：You're right.
Section 2：Giving a Patient Some Advice
(Lily gives Linda some suggestions about what the patient should do before having a CT scan of the abdomen.)
Nurse：Firstly，I'd like to remind you before you take the CT scan of the abdomen.You need to have nothing by mouth for 4 hours and not have taken any metal drugs or had a gastroscopy for at least a week.
Patient：All right.I will follow these guidelines for the sake of my health.
Nurse：OK.Since you're going to have your lower abdomen examined，please take a laxative 9 at 8 p.m.to clean your bowels a day before the test.
Patient：No problem.
Section 3：Reminding a Patient of Pre-test Preparation
(Lily reminds Linda of preparation before a test.)
Nurse：And don't forget to take 10ml iohexol 10 with 1000ml water orally at 5 a.m.
Patient：OK，I understand.
Nurse：Also，remember to remove metal objects，like jewelry，before having the test.
Patient：I see.I'll remember it.By the way，how long is it going to take？
Nurse：You'll probably be in Radiology 11 for about half an hour.
Patient：OK.Thanks for your directions.It's going to be OK for me，I think.
Nurse：You're welcome.I hope all turns out well for you.
2.Helping Protect Patients'Privacy During Tests
Conversation 1：Having an ECG Test
Section 1：Taking a Patient to the Treatment Room
(As a patient，Mrs.Jones is following a nurse's directions to have an ECG 12 test.)
Nurse：Nice to meet you，Mrs.Jones.You will need to have an ECG test.Is that OK？
Patient：All right.When？Now？
Nurse：Yes，could you please follow me to the treatment room？
Patient：No problem.
Nurse：Mrs.Jones，would you sit on the examination table？
Patient：Sure.
Nurse：Thank you.Mrs.Jones.
Section 2：Protecting a Patient's Privacy
(Some measures are taken to protect Mrs.Jones'privacy.)
Nurse：Now，I need you to unbutton your top.
Patient：Em…I feel a little bit embarrassed.
Nurse：Don't worry.The door is closed，and I will pull the curtains around.
Patient：Thanks.Em…(looking around unwillingly)
Nurse：(noticing the patient's expression)Are you still worried about something？
Patient：Hmm…(looking at another nurse in the room)
Nurse：(detecting the patient's apprehension)Oh，Linda，could you please give Mrs.Jones some privacy？
Linda：Sure.(leaving the room and closing the door)
Patient：Thanks a lot.It's very nice of you to be so considerate.
Section 3：Having an ECG Test
(Mrs.Jones doesn't feel embarrassed any more，therefore the process of having an ECG test is very successful.)
Patient：Do I also need to take off my bra？
Nurse：No，Mrs.Jones，just your top.
Patient：OK.
Nurse：Now I am going to put these pads on your chest，and these jellies will make you feel cold.
Patient：OK，that does not matter.
Nurse：OK，I have finished，you can get dressed.
Patient：Thank you.
Nurse：It's my pleasure，Mrs.Jones.
Section 4：Reporting the Test Results
(Mrs.Jones'husband asks the nurse for his wife's test results，and the nurse tells him that the test results can only be told to the patients.)
Mrs.Jones'husband：Hello，I'm Mrs.Jones'husband.Could you tell me my wife's test results for the ECG test？
Nurse：Nice to meet you.But the test results can only be told to the patients.I can ask Mrs.Jones for her approval，if she agrees，then I can give the results to you.
Mrs.Jones'husband：I understand.Thanks.
Nurse：My pleasure.
Conversation 2：Having an Ultrasound Scan 13
Section 1：Showing the Directions
(A nurse shows the way of the department for having an Ultrasound Scan to Miss Smith.)
Nurse：Miss Smith，the doctor says you need to have an ultrasound of your abdomen.
Patient：That's right.Could you please tell me where I have to go？
Nurse：I will show you where the department is.
Patient：Thanks a lot.
Section 2：Delivering Instructions before the Test
(Miss Smith is told to drink some water before having an ultrasound scan.)
Nurse：Miss Smith，you need to drink some water before the test.
Patient：Sure，how much？
Nurse：The nurse in the department will give you 3 glasses of water to drink before you have the test.You will need to wait for the results and bring them back to me.
Patient：Sure.
Section 3：Asking for a Patient's Approval
(The nurse tries to protect the privacy of Miss Smith after having an ultrasound scan.)
Patient：How long will I have to wait for the results？
Nurse：Not very long，Miss Smith，about 30 minutes.
Patient：Oh，that's a bit long.Can one of my friends help me get the results？
Nurse：Miss Smith，if you give permission then your friend can get the results for you.Otherwise，the test results can only be told to you.
Patient：Oh，I understand，thanks.
3.Calming Down an Impatient Woman while She is Waiting for an MRI 14 Test
Section 1：Listening to a Patient's Feelings
(Mrs.Faisal is waiting to have an MRI test，twenty minutes later，she gets angry.A nurse is listening to Mrs.Faisal's complaints.)
Nurse：Hello，Mrs.Faisal.Is there anything I can do for you？
Patient：I made an appointment for an MRI test at 10：00 a.m.It's already 10：20 a.m.What is taking so long？
Nurse：Oh，Mrs.Faisal.I'm really sorry to keep you waiting.
Patient：How long do I have to wait？The appointment paper says my appointment is for 10：00 a.m.It's already 20 minutes late.
Nurse：I'm really sorry，Mrs Faisal.A patient before you has to do an enhanced MRI.Thank you for your cooperation.
Patient：I see.
Section 2：Trying to Calm Down a Patient
(The nurse tries her best to make Mrs.Faisal feel less impatient，and hopes Mrs.Faisal can understand her.)
Nurse：Mrs.Faisal，let me check.(after returning)There are still two people ahead of you.It'll be your turn soon.Would you please wait for another 15 minutes？
Patient：Two？Another 15 minutes！That's ridiculous.
Nurse：I'm very sorry for the inconvenience，Mrs.Faisal.We have prepared free WiFi，newspapers and magazines for you while you are waiting.
Patient：I have a desperately tight schedule today.I can't accept this kind of explanation.
Nurse：I can totally understand how you feel.We are always working to improve our patients'waiting system.What about taking a nap on this sofa？I will call you when it's your turn.
Patient：Thanks，but I have no desire to sleep right now.
Section 3：Figuring out an Effective Way to Calm Down a Patient
(The nurse finally works out a way to calm down Mrs.Faisal.)
Nurse：You're going to have an MRI test.Why don't I tell you how to prepare for the test？When your turn comes，you'll be all ready to start.
Patient：OK.
Nurse：You will need to remove any necklace，watch，magnetic card，mobile phone or anything like that before having the test.You can do this now.
Patient：Thanks.
Nurse：It's my pleasure.It will be your turn very soon.
Notes
1.gastroscopy胃镜检查
【拓展】内镜检查的种类
esophagoscopy食管镜检查
duodenoscopy十二指肠镜检查
colonoscopy结肠镜检查
laparoscopy腹腔镜检查
2.anesthetic麻醉药
【拓展】麻醉相关词汇
anesthetizing forceps/anesthesia pliers麻醉钳
general anesthesia全身麻醉
regional anesthesia局部麻醉
dissociative anesthesia分离麻醉
anesthesia machine麻醉机
3.chronic disease慢性疾病
【拓展】慢性疾病的病种
hypertension高血压
diabetes mellitus糖尿病
mental illness精神病
osteoporosis骨质疏松
4.dentures假牙
【拓展】牙科相关词汇
dental牙科的
dentist牙医
dentistry牙科医学
tooth牙齿
5.endoscope内窥镜
【拓展】内窥镜的种类
ventriculoscope脑室镜
encephaloscope脑镜
rigid endoscope硬质镜
flexible endoscope弹性软镜
6.esophagus食管
【拓展】食管相关词汇
esophagectasia食管扩张
esophagitis食道炎
esophagopathy食管病
esophagotomy食管切开术
7.CT scan电子计算机横断层摄影(=computerized-tomography)
【拓展】常见人体部位扫描
brain scanning脑扫描
bone marrow scanning骨髓扫描
kidney scanning肾扫描
lung scanning肺扫描
liver scanning肝扫描
pancreas scanning胰腺扫描
8.abdomen腹部
【拓展】身体部位
chest胸
extremities肢
lung肺
lymph nodes淋巴结
joints关节
peripherals神经末梢
bowel肠
rectum直肠
9.laxative缓泻药
【拓展】泻药的类别
irritant laxative刺激性泻药
osmotic laxative容积性泻药
emollient laxative润滑性泻药
10.iohexol碘海醇
【拓展】其他相关造影剂
iopamidol碘帕醇
meglucamine diatrizoate泛影葡胺
iodixanol碘克沙醇
ultravist solution碘普罗胺
ioversol碘佛醇
magnevist马根维显
11.radiology放射医学
【拓展】放射医学相关词汇
radiographer放射科技师
department of radiotherapy放射治疗科
radiologist放射科医师
radiologic diagnosis X线诊断
12.ECG心电图(=electrocardiogram)
【拓展】其他类似检查
electromyogram(EMG)肌电图
electroencephalogram(EEG)脑电图
phonocardiogram心音图
rheohepatogram肝血流图
13.ultrasound scan超声波扫描
【拓展】超声波相关词汇
B-ultrasound B超
short wave diathermy machine短波电疗机
color doppler ultrasound彩超
ultrasonic wave apparatus超声波机
14.MRI核磁共振成像(=magnetic resonance imaging)
【拓展】MRI检查适应症
nervous system神经系统
cardiovascular system心血管系统
abdominal organs腹部器官
pelvic organs盆腔器官
Communication Strategies
I.When a patient feels anxious before having a test，what can you do？
Tip 1：Use active listening strategies.Let your patients vent their nervousness，and listen to them calmly.Show your concern for them.You can smile while nodding your head，and lean towards the other person，which can make a patient feel more relaxed.
Tip 2：Make empathetic responses.Explain that anxiety is a normal reaction.It is not uncommon to see that people feel worried or anxious before having some tests，like a gastroscopy.
Tip 3：Tell your patients what they should do before，during，and after the test.It will also help you if you identify situations which cause tension.
Tip 4：Try to avoid words which increase anxiety.For example，it is wise of you to adopt"discomfort"rather than"pain".
Tip 5：Choose a calm and reassuring way of talking.
II.How can you protect a patient's privacy？
Tip 1：Make sure that curtains are drawn and doors are closed when a patient is having a test，if necessary.It's of great importance to maintain the patient's privacy to protect his/her dignity.
Tip 2：Be able to read a patient's expression.Sometimes，some patients are unwilling to express their thoughts directly when it comes to an awkward situation.Thus，we need to interpret their nonverbal behaviors.
Tip 3：Do not tell the test results to anyone else，even the patient's family members.
Tip 4：Only ofter you have asked patients for their approval can you give the test results to others.
Tip 5：It's very wise of you to leave the place where another nurse is giving a test to a patient，if necessary.
III.What would you do if a patient does not have much patience to wait for a test？
Tip 1：Be honest with the patient.When the patient asks how long they still need to wait，you're expected to respond truthfully.
Tip 2：Offer different sorts of materials.It's wise of you to provide materials to those who need to wait for a test，such as newspapers，magazines，free WiFi，a comfortable couch，some therapeutic pamphlets，brochures and drinks.
Tip 3：Catnap.Taking a 5 or 10 minutes'nap can let the patients feel refreshed.
Tip 4：Provide instructions.The guidance about a test is a good way to let patients focus their attention away from their impatient feelings towards waiting.
Tip 5：Speak in a soft and calm manner.Tender voices help to make the impatient patients calm down.
Useful Patterns
Communicating with a nervous patient before having a test…
1.Is everything OK？
2.Hospitals have changed a little bit，but don't worry.
3.You can ask as many questions as you like.
4.It's completely normal for you to be tense/nervous.
5.People usually feel less anxious when they know what to expect.
6.I am very glad that you can share your feelings with me.
Communicating with a patient when you need to help to protect his/her privacy…
1.The door is closed，and I will pull the curtains around.
2.Are you still worried about something？
3.Could you please give her some privacy？
4.I have finished，you can get dressed.
5.The test results can only be told to the patients.
6.You will need to wait for the results and bring them back to me.
Communicating with an impatient patient…
1.Is there anything I can do for you？
2.I'm really sorry to keep you waiting.
3.There are still two/three/four/five…people ahead of you.
4.It'll be your turn soon.
5.Would you please wait for another 15 minutes？
6.I'm very sorry for the inconvenience.
7.We have prepared free WiFi，newspapers and magazines for you while you are waiting.
8.I can totally understand how you feel.
9.We are always working to improve our patients'waiting system.
10.What about taking a nap on this sofa？
11.I will call you when it's your turn.
12.Why don't I tell you how to prepare for the test？
Role Play
Mr.Frank，a senior citizen，is waiting to have his blood pressure taken.When he realizes there are fifteen people ahead of him，he becomes impatient and anxious.As a nurse，how can you help him feel less impatient？Try your best to make a dialogue between Mr.Frank and you，then show it to the others.
