For those of you who are unfamiliar with Lulu - it is a self-publishing site which works in the same way as Amazon. Click on the book you want and you are directed to a payment page.
Abbreviations are used frequently in hospitals, however, in recent years there has been an insistence on avoiding abbreviations or symbols which may be confusing. This is most important in drug administration. An excellent website for national standards regarding acceptable abbreviations in Australia is the Australian Commission on Safety and Quality in Health Care. Find it at http://www.safetyandquality.gov.au/
Read the pdf called ‘Recommendations for Terminology, Abbreviations and Symbols
used in the Prescribing and Administration of Medicines’
You will find a set of tables at the end which explain changes in some abbreviations which were changed because they were considered to be unclear. Some of you who have worked in other English-speaking countries will notice that there are a few differences between Australian abbreviations and those you may be familiar with. I’ll look at these later.
The abbreviations in the table which you will probably be dealing with in the stimulus material of the OET writing subtest are those relating to the administration of medications, specifically:
* TIMES OF ADMINISTRATION - daily ( not OD or d), bd (not BID), tds ( not TID)
- mane ( in the morning) , nocte (at night) , stat (give immediately), prn (give whenever necessary), OTC (over-the-counter medicines), TCM (Traditional Chinese Medicine)
* FREQUENCY OF ADMINISTRATION – every 4 hours -add times e.g. 06:00,10:00 etc- not 4/24
* DAYS, MONTHS,WEEKS - I day (not 1/7), 1 mth (not 1/12) and 1 wk (not 1/52)
The abbreviations 4/24 or 6/24 etc are still quite common in IV fluid administration, however, the recommendation is to write 4 hr or 6 hr.
* DOSAGE – g, mg , mcg (or microgram), ml, units, mg per ml
Other abbreviations have been removed from the list of accepted abbreviations because they are felt to be dangerous or ambiguous. The most common are:
Form to be written now:
Units (write in full) e.g. 5 units Humalog insulin
Sliding Scale (write in full) e.g. sliding scale insulin
R eye / L eye/ both eyes (specify which eye/eyes)
As well as abbreviations, some symbols are also avoided. For example, when charting a urinalysis result, we used to write + ( and say ‘One plus of protein’) , ++, +++ etc .This is an easy one as you can use the correct amount which is also included on the label of the urinalysis sticks. It is less clear if you describe the discharge of a wound as being ‘++ drainage from wound drain’. This supposedly meant ‘ a moderate amount of drainage’ but it was never clear ‘whose’ moderate we were referring to. One nurse’s idea of ‘moderate’ may not be another nurse’s idea of moderate. It is now required that you say exactly how much drainage there is e.g. 120 ml drainage. It is quite acceptable to write ‘minimal drainage of <20 mls’ if it is not possible to accurately measure a very small amount.
Differences from country to country
1. Nurses who have worked in the UK may be confused by the abbreviation 1/24 as the abbreviation '1to the power zero' (see below) is used for ‘hourly’ or ‘over an hour’. In Australia. this abbreviation would be read as ‘primary’ e.g. a primary carcinoma and is on the list of confusing abbreviations.
2. In Australia, the abbreviations bd, tds and qid are used. In the UK, bd, tds and qds are used.
See below: symbol used to mean 'primary' in Australia.
I was very pleased to hear the results of one of my students who got Bs in everything except writing - one student even scored an A in writing!. What a fantastic result. It is lovely to hear of one student who was able to join her husband in New Zealand now that she can work there as an RN.
I recently had a chat with Sujata Stead and Barbara Zhang of Cambridge Boxhill Language Assessment. I wanted to find out more about the Occupational English Test as I had read about some changes coming in. A very informative chat. I had started with the feeling (shared by some of my students) that the writing test was not relevant for nurses. After all, we said, nurses don't write referral letters any more. However, I have been won over after hearing about the amount of research which has been undertaken to assess the usefulness of this type of writing test.
It comes down to the fact that the writing test assesses the ability to scan patient information which is presented in an authentic format i.e effectively a discharge summary. Whilst the writing of a referral letter may not be usual practice for ward nurses, it is still the practice of certain nurses e.g. in specialised clinics. For ward nurses, the ability to structure patient notes or an incident report in a way that is clear and understandable is always needed. So, my conclusion is that the format of a referral letter is transferrable to other written texts.
Another question was about the lack of feedback for students on their marks. I have students who have attempted the OET several times, receiving a 'C' in writing but seeming to be improving in their writing during their practice sessions. Their wish was to know where they were losing marks i.e.in what criteria. The answer was that it is felt that by pointing out errors, students tend to concentrate only on correcting those mistakes the next time and neglect the 'whole picture'. I can appreciate this but welcome the thought that there may be more information available soon on marking criteria.
I feel the OET is a very useful test to assess the long-term language abilities of future healthcare workers. In other words, the use of appropriate spoken language in a healthcare oriented role play can be recycled in authentic practice. Communication skills such as empathising with a patient, reassuring a patient before a procedure, gently advising a patient to change lifestyle habits, convincing a patient to remain in hospital for treatment, dealing with a patient who is agitated and many more. In the same way, the writing task should help to predict the healthcare worker's ability to produce appropriate written texts such as variance reports on a care pathway, adverse incident reports, messages to colleagues, requests for treatment or assessment of patients and many more.
Testing English for Medical Purposes carries an added responsibility. The OET is not only testing basic English communication, it is testing safe practice from a linguistic point of view. It is not only desirable but vital that communication verbally and in written forms should be clear so that patient safety is not compromised.
I am looking forward to developing my skills in teaching OET preparation in the future.
I continue to be asked for materials for the OET in nursing. I have decided to gather some notes together to print as a self-published book which should be ready for next year's tests.
'English test for healthcare professionals now more accessible' is an article worth reading. It explains the moves to make the OET a more attractive test for Healthcare Professionals. There are some simple things which you can do right now to prepare for the test:
For the writing:
1. Put yourself in the position of a real situation. You, the ward nurse, are writing to another HCP for something to be done.What are you likely to be asking for?
As you can see, there are probably a limited number of reasons for writing a referral letter. Start to gather the vocabulary you need for each possibility. You will come across phrases or collocations (words which 'go together') in your reading.E.g.
assess a wound - look at a wound to check on healing and check for infection.
monitor medications - check to see that the patient is taking the correct meds and the correct dose
encourage independence with personal hygiene - help patients do as much as they can by themselves.
liaise with the GP - speak to the GP regarding patient care.
And so on.
2. Revise the structure of a referral letter. How are you going to organise the letter? How will a referral letter for a post-op patient ( e.g. after a total hip replacement) differ from a medical patient (e.g. after sleep studies for OSA)?
For a surgical patient: you may talk about recovery from the op (any problems?) ,pain relief,dressings and suture/clip/staples removal. Also, mobility (need for mobility aids and for how long).
For a medical patient: you may talk about medication changes or compliance problems, new equipment (glucometer, CPAP), assessment of dementia, ongoing difficulties with personal hygiene.
One of the most important aspects of the OET writing test is the ability to organise your information and present it so it is clear to the reader of the letter. The recipient of your letter should be able to start from the beginning (the reference - Re: Mr Bill Patient,aged 78) , look at the first paragraph to get a general idea why you are writing and finally get to the end where you are specific about what you want the recipient to do. Once again, imagine this is an authentic situation. The reader of your letter has a short time frame to see what the letter is about.
3. Revise sentence structure. Look at simple sentences first. Then revise the use of relative clauses and conjunctions to make your sentences longer. Remember that a short sentence that is well written is much better than a long sentence which doesn't make sense!
Reading and Writing go together
Read as much as you can and take note of how the sentences are structured. ABC Radio National's Health Report is a great resource for this. Listen to a podcast before taking a look at the transcript. Listen again but this time follow the transcript. Highlight verbs and the prepositions which follow e.g.
refer ( a person) for (treatment)
Keep a notebook!
Write down words and phrases as you hear them or read them. Studying for the OET takes time. Don't leave it until the last minute. The advantage of the OET is that you will continue to use the vocabulary when you start working as a nurse in Australia or New Zealand - it will not be wasted!
I seem to be receiving a lot of emails and Skype messages asking for free OET hints lately. This is a real dilemma for online teachers and writers of ESP materials. Basically, the materials we write and teach are our livelihood - it would be like asking your teacher for free private lessons. You wouldn't do it.
Despite this, I do add some free tips to this site, my face book page (English for Nursing and Healthcare) and through You tube videos. I have several students about to sit an OET for nurses on October 5. They are working hard to ensure that they understand the format of the test (in all areas) and that they are practising as many role plays as possible to ensure that they can deal with any situation which is presented.
So, here are my free tips today:
1. Start preparing for the test well ahead of time. There are a lot of tricky parts to the test which you need to be aware of. E.g.
Speaking - getting sidetracked by the interviewer, knowing how to speak most of the time but still include the 'patient', knowing how to start the conversation and end it.
Listening - picking out key terms and context, particularly in Part B which is more challenging.
Writing - setting out the letter properly, keeping to the word limit, organising the letter in 3-4 coherent paragraphs with only relevant information in them. Remembering who you are writing to and why (what you want them to do for you).
Reading - being aware that there will be a variety of texts - some graphs or tables are a challenge. The answer gapfill will usually have words and phrases which have the same meaning as words or phrases in the text.
Many students find the writing section the most challenging. This is often because it is an artificial exercise. At no time in your nursing degree ,or as an RN, will you write a referral letter these days. You will probably never have practised this before. Try to see it as an exercise in:
1. Organising relevant information into sections (paragraphs in this case)
2. Writing a clear statement of what is needed ( think of it as similar to writing nursing notes)
Keep your sentences relatively simple - 180-200 words is not long enough to expand on much.
Make sure you know how to write the address, date and salutation correctly as well as the ending. - These are easy marks to gain or lose!
Spell any words in the stimulus material correctly!
I received a post in one of my forums about going to Australia to work as a nurse. I seem to be receiving a lot of requests for information about the language requirements to be able to register as a nurse in Australia and also New Zealand. I have added my reply to the forum post here in case it is useful to others.
I have tried to talk about some ways that you/your students can improve on the four skills (reading,writing,speaking and listening). As teachers, we know that this takes practice, however,many people leave it too late to start laying the groundwork. We have all been there!
I used to periodically harangue my students with the strong advice that they start a notebook and add terms or phrases as they heard them. The notebook needed to be small enough to go into a bag or pocket. It needed to be looked at frequently. The words needed to be spoken aloud - to a willing friend or relative, if possible. All these actions start to establish the vocabulary in the brain and memory. But it takes time and it must be a frequent action.
So, on to the forum post:
1. Passing an English test to be able to register as a nurse. This website has all the information you needhttp://www.nursingmidwiferyboard.gov.au/. Look at Criterion 2 - this is the section about English language competency. You need to do either the IELTS or the OET (Occupational English Test). More and more nurses seem to be doing the OET these days. This is why I now teach online courses for OET Writing and Speaking. You can find information about the structure of the OET at http://www.occupationalenglishtest.org/.
2. Develop the skills:
I can give you some hints now on preparing for each section yourself:
Reading - you may be given 4 short texts on the same topic. Then you complete a gapfill text. You have to work out where the information is in the 4 texts. Often, the gapfill uses expressions from the text but in different words.
The skill you need to develop is SCANNING FOR KEYWORDS. It's a good idea to read as many health texts as you can. Print out the text you are reading and take a highlighter pen to find the 1 -2 keywords in each sentence.
Also, learn how to read statistical information. Find examples of tables of numbers e.g. relating to a study.
A good place to find articles is Medscape (www.medscape.com). It is free to register and you can then look at any article on the site.
Listen - this is quite difficult as you may get an unfamiliar topic. The speed is quite fast. You may not be familiar with the Australian accent. Once again, try to listen to as many podcasts as you can (ABC Radio-the Health Report is good). Start listening for the keywords in each sentence. Remember that people often put a bit of emphasis on keywords.
Writing - this is very challenging for many people. You will usually have to write a referral letter, perhaps to a Community Nurse or a Clinic Nurse. You have 1 - 2 pages of stimulus materials to read. This is like a patient summary that you find when you work in a hospital. It will contain admission and discharge information, past medical history and social history. There are usually a few abbreviations which you need to understand. You scan the materials for relevant information and then write a letter of 180-200 words. Unfortunately, you are not allowed to make any notes during the 5 minutes reading time. You must set out the letter using the correct letter format.Many people have difficulties setting out the address and salutation (e.g. Dear Mr So-and-so,)
Speaking - This consists of 2 role plays. You will be given a role play card with the scenario and task. You will be the nurse. The interviewer is the patient. It is important to know that the interviewer is not marking you - that is done by other people after listening to the recording of your role play. Each role play is 5 minutes long. You need to show that you can start the conversation and keep it flowing in a natural way.It does not matter if you are unfamiliar with the health topic of the role play - it is the ability to communicate effectively that is being tested.The interviewer may try to take you off track or play the part of a patient who does not want to listen to your advice. You have to be able to deal with this.
If you choose the IELTS, the structure is similar,i.e.Reading, Writing,Speaking and Listening are tested. The advantage of the OET is that you may have more understanding of the topics. Some people prefer the OET, some do not. It's a personal choice. It's a good idea to go to the websites of IELTS and OET and look at the sample materials before deciding.In the end though, you must do an English test and pass at a fairly high level (minimum of 7 in each section for IELTS, minimum of B in each section for OET).
I have included a video I made giving some hints on the OET Writing for Nurses sub-test. I am finding that You Tube capture is an excellent way to keep in contact with students and potential students from all over the world.
The OET or Occupational English Test is a healthcare profession-specific test which needs to be passed before working in Australia or New Zealand.
co-author of 'Cambridge English for Nursing' Pre-Intermediate and Intermediate+
- Medical English: Spelling