Health Science Notes
Patient Rights and Responsibilities: Legal Part I
Human, Civil, and Client Rights
Human rights: Basic, fundamental rights that belong to all people.
Civil rights: Privileges and protections given to all U.S. citizens by Constitutional, federal, state, and local law.
Client rights: Rights that people are entitled to when they are in a relationship with a professional.
The Patient’s Bill of Rights
A list of rights honored by health care providers. Providers must:
Give accurate, understandable information.
Identify themselves.
Inform patients' decision making.
Answer questions patients have.
Be considerate.
Treat with dignity.
Never discriminate.
Never abuse.
Keep information confidential.
Not disclose without permission.
Inform of grievance process and respond objectively and promptly.
Right to Choose Providers
Patients can:
Choose providers.
Have access to specialists.
Receive emergency care anywhere, including out-of-network services.
Make decisions about their care.
Select advance directives.
Donate body.
Review records.
Obtain copy of records.
Make a complaint.
Patient Responsibilities
In addition to patient rights, patients also have responsibilities:
Giving complete and truthful information to physicians.
Asking for information about health care.
Informing physicians of advance directives.
Following the physicians’ instructions.
Respecting health care workers.
Ethics
Ethics: Lesson 2
Laws: Rules of conduct enacted and enforced by governments.
Ethics: Rules of proper conduct among a group of people, such as a religion or profession.
Morals (personal ethics): An individual’s personal values.
Code of Ethics: Lesson 2
Code of ethics: A list of written statements describing proper conduct for a group of people.
A code of ethics for health care workers includes:
Autonomy
Fidelity
Beneficence
Nonmaleficence
Veracity
Confidentiality
Justice
Professional Code of Ethics: Lesson 2
Associations for many health care professions have established specific codes of ethics.
Examples include the Code of Ethics of the American Association of Medical Assistants, the American Nurses’ Association, etc.
Health care workers should become aware of their profession’s code of ethics.
Bioethical Dilemma
Ethical dilemmas: Occur when moral beliefs conflict.
Bioethical dilemmas: Dilemmas that involve health care and biological sciences.
Ethical Examples:
Delivering Bad News.
Disagreements With the Patient's Family.
Revealing Mistakes to Patients.
Caring for Patients With Little or No Insurance.
Having Impaired Patients' Driver's Licenses Taken Away.
Reporting Impaired Colleagues.
Bio Ethical Examples:
Genetic testing and screening.
Sexuality and gender.
Environmental ethics.
Environmental Safety
Fire Safety: Lesson 2
Objectives
Identify fire prevention guidelines
Define the acronyms RACE and PASS
Identify the types of fire extinguishers
Fire Prevention
The best way to practice fire safety is to prevent the fire from ever happening in the first place.
Obey “No Smoking” signs.
Check electrical equipment for damaged cords.
Do not overload electrical outlets.
Dispose of waste material in proper containers.
Store flammable material in proper containers.
Clean up flammable liquid spills immediately.
Keep hallways and doorways clear of clutter.
Fire Safety
It is important to know how to be prepared should a fire emergency occur. Remember what steps to take using acronym RACE.
R - Rescue: Anyone who is not involved in extinguishing the fire must leave the scene.
A - Alarm: Pull the alarm or assign someone to pull the alarm.
C - Contain: If possible, keep the fire in an enclosed area by closing windows and doors.
E - Extinguish or Evacuate: If the fire is small and in a confined area, extinguish the fire with a fire extinguisher. If the fire is large, move everyone, including yourself, out of danger.
Fire Safety Rules
Most importantly, stay calm.
Evacuate patients in immediate danger first. Assist patients who can walk, followed by patients in wheelchairs and beds.
If possible, do not leave patients alone.
Never use elevators in a fire evacuation.
Do not open a window for ventilation; oxygen will feed the fire.
Feel doors before opening them. If the door is hot, do not open it.
Fire Safety Rules (continued)
If you see smoke or fire on your escape route, try a secondary route. If it is necessary to exit through smoke, stay low to the floor and crawl to your exit.
If fire is blocking all of your exits, stay in a room with the door closed. Flag for help at a window.
Because every facility is different, be sure to learn the fire safety procedures and evacuation plan at your facility.
Evacuation Plans
Every health care facility should have a written evacuation plan, posted in plain sight on every floor and in every wing of the facility.
Emergency evacuation plans must contain:
Procedures for reporting emergencies, such as dialing 911 or pulling a manual fire alarm.
A description of actions employees should take during evacuation.
Escape route diagrams
A primary exit is the closest exit
A secondary exit is usually further away and should only be used if the primary exit is blocked by smoke or fire.
Fire Extinguishers
Five basic types of fire extinguishers:
Type A is made of pressurized water and should be used on common combustibles, such as wood.
Type B is made from carbon dioxide and is useful for flammable liquid fires, including grease, gasoline, and oil.
Type C is composed of potassium bicarbonate and is used to put out fires that are electrically energized.
Fire Extinguishers (continued)
Type D is used on flammable metals. Its makeup depends on the type of flammable metal it was intended for. Because each Type D extinguisher is highly specific, employees should read the label and become familiar with the uses of this extinguisher before a fire ever occurs.
Type ABC is made of a chemical compound and can be used on any A, B, or C fire. ABC is the most common type of fire extinguisher.
Using a Fire Extinguisher
If a fire is small and in a confined area, use a fire extinguisher to put out the fire as quickly as possible. PASS can help health care workers remember how to operate a fire extinguisher. PASS stands for:
P - Pull the pin
A - Aim at the base of the fire
S - Squeeze the handle
S - Sweep the nozzle from side to side
Using a Fire Extinguisher
If a fire has spread to several rooms and the flames have become large and uncontrollable, the facility must be evacuated immediately. It is better to evacuate yourself and your patients to safety than to try to save the building.
Summary
Identified fire prevention guidelines
Defined the acronyms RACE and PASS
Identified the types of fire extinguishers
Blood Pressure Notes - 3/25
Blood Pressure - What and Why?
Blood pressure is the force of blood against artery walls when the heart beats
Systolic indicates the left ventricle contracts to push blood into arteries.
Diastolic indicates the pressure on the artery
Medical Terms
Hypo - low
Hyper - High
Tension - pressure
Hypertension - High pressure
Hypotension - Below pressure
Systolic
Heart is contracting
Top number
Higher than diastolic
Diastolic
Heart is relaxing
Bottom number
Lower than systolic
Vitals - 2/28
What are vital signs - groups of the four to six most important medical signs that indicate the status of the body’s vital functions.
What are we measuring when we measure pulse? Pressure of blood pushing against the wall of the artery as the heart contracts.
What can Abnormalities Indicate - can signal disease.
What may increase your pulse - elevated too high - exercise, stimulants, excitements, fever, shock
Decrease - sleep, depressants, heart disease, coma
Brady stands for slow
Tachy stands for fast
Cardia stands for heart
Palpate: to touch
Palpitation: examination by applying slight pressure to a pulse point with fingertips.
Auscultate: to listen
Auscultation: examination by listening, usually with a stethoscope.
What does rate measure: number of beats per minute (#/per min)
Rhythm: pattern of beats (regular or irregular)
Volume: character, or strength, of beats (strong or weak)
Normal range: 60-100
Bradycardic Range: 100>
Tachycardic Range: <60
Q: Why do we knock? A: To help them alert them that you are there.
Q: How would the patient feel if we entered the room without knocking? A: The patient would feel uneasy.
Q: How hard/soft should we knock A: We should actually be knocking at a medium range
Examples you would use:
Good Morning
Good Afternoon
Good Evening
Hello
It’s nice to meet you
Examples you would NOT use:
Hey
Yo
Sup
Yah
Q: What kind of tone do we use? A: Professional tone
Q: What volume is appropriate for which patient? A: A moderate voice level
Examples: Nurse, Doctor, etc.
Q: Why is it important to identify your position? A: To alleviate confusion
Q: Why is it important to identify your patient? A: To see what they are in need of help with.
Q: What are some scenarios in which a patient can be harmed if not properly identified? A: Preparing medication for a specific patient.
Examples: Taking a set of vitals, starting an IV, etc -To ease your patient’s comfort, so they can know what will be happening.
Patient Introduction - 1/13/2025
Step - 1: Knock! Knock! Knock!
Step - 2: Greet Your Patient
Step - 3: State your name
My name is ___ (First/Last name) -No Nicknames
Step - 4: State your position
Step - 5: Identify your patient by name and birthday?
Step - 6: Explain Your Procedure
Step - 7: Ask our patient if they have any questions
Brainstorm some ways you could help a patient be more comfortable
Examples: Extra blanket, water, dim lights, etc.
EXIT TICKET: Q: What is today’s take away for you? A: New terms such as geatric, as I never knew a term could just describe age groups.
Ensuring understanding and allow for questions is a great way to make your patient feel safe and comfortable.
Step - 8: Asking your patient if they are comfortable
Temperature - 1/16/2025
Vital Signs: Group of 4 to 6 most important medical signs that indicate the status of the body’s vital sign functions. These measurements are taken to help assess the general physical health of a person, give clues to possible disease, and show progress toward recovery.
The 4 Vital Signs:
Temperature
Pulse
Respiration
Blood Pressure
Vital sign - Temperature:
Measure balance between heat body loses and heat body produces
Heat is lost through perspiration, respiration, excretion, and slow metabolism.
Heat produced by metabolism and muscle and gland activity.
Homeostasis - stable condition of body’s organs, tissues, and systems
Abnormal temperature affects homeostasis, which affects health of patient
Methods for taking a temperature:
Factors that affect temperature:
Increase in temperature illness, infection, exercise, air temperature
Decrease in temperature starvation, sleep, decreased muscle activity, disease, air temperature
Other factors include mouth-breathing, metabolism, time of day
Hypothermia:
Generally below 96 F
Death below 93 F
Fever:
Generally above 100 F
Hyperthermia:
Generally Above 104 F
Extremely dangerous over 106 F
Q: Why are infrared thermometers preferred?
A: Infrared thermometers are preferred because they give instant results, sterile, and clean.
Tympanic: Ear
Temporal: Forehead
Oral: Mouth
Rectal: Rectum/Anus
Axillary: Armpit
Leadership
Leadership - the skill or ability to encourage people to work together and do their best to achieve common goals.
Leader - individual who leads or guides others or who is in charge or in command of others.
Leadership characteristics:
Develop their own efforts
Promote positive changes that benefit their professions and the people they serve .
Leadership in a group passes from person to person as each individual contributes to the achievement of the group’s goals.
Leadership Styles
Democratic - encourages the participation of all individuals in decisions that have to be made or problems which need to be solved.
Listens to the opinions of others
Bases decision on what is best for the group as a whole
Laissez-faire - believes in noninterference in the affairs of others
Informal type of leader
Minimal rules or regulations
Allows group to function independently with little to no direction
Autocratic - maintains total rule, makes all of the decisions, and has difficulty delegating or sharing duties.
Also known as a dictator
Does not ask for the opinion of others, emphasizes discipline, and expects others to follow directions at all times.
Teamwork
Teamwork - the collaborative effort of a group to achieve a common goal or complete a task in an effective and efficient way.
Provide quality healthcare to patients
Improves communication
Improves continued care
Roles must be understood by each member of the team
Clarifies each member’s responsibilities
Establishes goals the team wants to meet
Each team member must listen, be honest, express their opinion, and be willing to try different solutions.
Time Management
Time management - system of practical skills that allows an individual to use time in the most effective and productive way possible.
Prevents or decreases stress by putting the individual in charge
Keeps things in perspective when events are overwhelming
Increases productivity
Use time more effectively
Improves enjoyment of activities
Provides time for relaxing and enjoying life
Time Management Strategies Graduate School Finals Week Schedule:
Three 30 page single spaced papers
One 100 question final exam
Two 45-minute presentations
Teach four undergraduate labs
Create final for undergraduate labs
Finish research two experiments
Social/Personal Time:
Best friends birthday party
Running group (half marathon training)
Personal and Professional Characteristics
Responsibility
To be able to identify with and understand another person’s feelings, situation, and motives.Discretion
Using good judgement in what you say and do.Team Player
Acceptance of Criticism The ability to tolerate and understand without getting upset.Honesty
Truthfulness and integrity. The ability to tolerate and understand without getting upset Dependability Trustworthy and reliable.Willingness to Learn Accept criticism or judgement and learn from it. Enthusiasm Enjoyment of work and displaying a positive attitude
Responsibility
Be willing to be held accountable for your actions.
Do what you are supposed to do.
Others can rely on you and know you will meet obligations.
Discretion
Using good judgement in what you say and do
Be discreet and make sure patients’ rights are not violated.
Information should not be told to anyone without prior permission.
Team Player
A person who plays or works well as a member of a team or group.
By working together, a team can accomplish goals much faster than an individual.
Each member of a health care team will have different responsibilities, but each member must do his or her part to provide the patient with quality care.
Learn to work well with others.
Ethics
Summary
All characteristics and attitudes must be practiced and learned.
Some take more time to develop than others.
Be aware of these characteristics.
Strive constantly to improve.
All of these characteristics will help you provide good patient care.
They will make you a valuable asset to your employer and others.
The History of Healthcare
Ancient Times
Prevention of injury from predators
Illness/disease caused by supernatural spirits
Superstitious
Exorcise evil spirits
Herbs and plants used as medicine
Plant leaves chewed now some used as IV or pills
Some tree bark used to treat malaria or fevers
Poppy seeds used to make morphine
Egyptians
Earliest to keep accurate health records
Superstitious – eye of Horus
Identified certain diseases
Pharaohs kept many specialists
Egyptians
Priests were the doctors
Temples were places of worship, medical schools, and hospitals
Only the priests could read the medical knowledge from the god Thoth
Egyptians
Embalming
Done by special priests (NOT the doctor priests)
Advanced the knowledge of anatomy
Strong antiseptics used to prevent decay
Gauze similar to today’s surgical gauze
Egyptians
Research on mummies has revealed the existence of diseases
Arthritis
Kidney stones
Arteriosclerosis
Medical practices still used today
Enemas
Circumcision
Closing wounds and setting fractures
Jewish Medicine
Avoided medical practice
Concentrated on health rules concerning food, cleanliness, and quarantine
Moses: pre-Hippocratic medical practice
God was the only physician
Enforced Day of Rest
Greek Medicine
First to study causes of diseases
Research helped eliminate superstitions
Sanitary practices were associated with the spread of disease
Hippocrates (Father of Medicine)
no dissection, only observations
took careful notes of signs/symptoms of diseases
disease was not caused by supernatural forces
Greek Medicine
Aesculapius Staff and serpent symbol of medicine temples built in his honor because the first true clinics and hospitals
Roman Medicine
Learned from the Greeks and developed a sanitation system
Beginning of public health
First to organize medical care (army)
Room in doctors’ house became first hospital
Public hygiene
flood control
solid construction of homes
Dark Ages (400-800 A.D.) and Middle Ages (800-1400 A.D.)
Medicine practiced only in convents and monasteries
custodial care
life and death in God’s hands
Dark Ages (400 –800 A.D.) and Middle Ages (800-1400 A. D.)
Crusaders spread disease
Cities became common
Special officers to deal with sanitary problems
Realization that diseases are contagious
Quarantine laws passed
History of Healthcare Activity
16th to 17th
Anatomy of the body
Microscope invented
18th century
Smallpox vaccine
Oxygen discovered
Bifocals and stethoscope invented
19th & 20th
Importance of handwashing
Theory of communicable diseases
Penicillin
Historical Figures in Healthcare Activity
Edward Jenner Discovered smallpox vaccination
Louis Pasteur Discovered germ theory of communicable diseases
Joseph Lister First to use antisepsis in surgery
Alexander Fleming Discovered penicillin
Jonas Salk Discovered a killed polio virus causes immunity to polio
Wilhelm Roentgen Discovered x-rays
Communication verbal
Communication - sending or receiving information.
verbal - the exchange of information using words − both spoken and written
nonverbal - sending and receiving wordless messages
Types of Communication in Healthcare
Promoting health information
public health or education
Health provider and patient communication
providing patients with information such as treatment options, lab or test results, etc.
Team communication
interdisciplinary team communication
various shifts
updates to patient care plans
Written communication
patient note documentation
Uses of Verbal Communication
Interactions with patients, families, and co-workers
Giving reports to other healthcare providers
Documenting patient care
All relevant clinical findings or results
The decisions made or agreed upon and who made those decisions
Patient education or information provided
Medications or treatments performed
Who is writing the patient record - date and time
Effective Communication
The message must be clear
language the patient can understand
Deliver message in a clear concise manner
good grammar and pronunciation
avoid slang terms
do not speak too fast or slow
Effective Communication
The receiver must be able to hear and receive the message
alternate methods of communication may be needed
different language, medicated, use of interpreter
Interruptions or distractions must be avoided
No phone use while delivering a message
Be aware of environmental factors (ex) tv, radio, room temperature, etc.
Barriers to Communication
Hearing loss
Use body language (gestures or signs)
Speak clearly in short sentences
Face the patient when speaking (read lips)
Write out messages
Ensure hearing aids are working properly
Walk up and get the individuals attention when you are introducing yourself
Avoid chewing gum, covering your mouth, or turning your back to the patient
Barriers to Communication
Impaired Vision
Describe what is happening and what you want the person to do
Announce your presence as you enter in the room
Use touch to orient the person to where you are located
Stand next to the person and in good light
Do not move items without tell the patient
Tell your patient when you are leaving
Barriers to Communication
Trouble Speaking
Ask direct questions such as yes or no
Allow the patient adequate time to respond
If you are unable to understand, validate what they are saying
Encourage your patient to point, nod, or write to communicate what they are saying
NON Verbal Communication
Nonverbal communication
expresses more of the meaning of a message than verbal communication
Understanding the message
7% spoken by words
38% the tone of one’s voice
55% by body language
Types of Nonverbal Communication
Gestures
Express a variety of feelings
content
hostility
approval
affection
Can be used in addition to words
Differ by culture
Body Language and Posture
Crossing arms - barrier between you and and the receiver
Erect posture - good health and positive attitude
Slumped posture - fatigue
Clenched fist - angry
Hands on hips - challenging or resisting
Pointing finger - assertiveness
Leaning on elbow with chin in hand - bored
Facial Expressions
Face is the most expressive part of the body
Seven universally accepted emotions
Fear
Anger
Surprise
Contempt
Disgust
Happiness
Sadness
Eye Contact
Often initiates communication
Good contact = respect, willingness to listen, and keep communication open
Looking away = anxiety, defenselessness, or avoidance of communication
Cultural differences
Eye contact may be an invasion of privacy
Eye contact considered disrespectful
Touch
Positive messages provide:
affirmation
reassurance
share warmth
approval and emotional support
Negative messages provide:
anger
frustration
punishment
invasion of personal space
Always ask permission or consent to touch a patient.
Five Emotional Stages Experienced by Dying Individuals
Denial
Anger
Bargaining
Depression
Acceptance
Physical, Social, and Emotional Fears of Death
Physical
Helplessness, dependence, loss of physical abilities, mutilation, and pain
Social
Separation from family, leaving behind unfinished business
Emotional
Being unprepared for death and what happens after death
Fear Interventions for Patients
Talk as needed
Avoid superficial answers “It’s God’s will”
Provide religious support as appropriate
Stay with patient as needed
Work with families to strengthen support
Pulmonary
Unable to oxygenate blood
Assess for poor oxygenation-skin Pale skin: blue or purplish, mottled, or cool skin Dark skin: look at mucous membranes, palms of hands, and soles of feet
Somatic death or death of the body
Series of irreversible events leading to cell death
Causes of death varies
Cardiovascular
Heavy load on the heart when the lungs are failing and not functioning properly
Heart is not received needed oxygen
Heart is strong enough to circulate blood to the body
Blood backs up causing failure
Pulmonary and liver congestion
Blood Circulation
Decreased
May have a “drenching sweat” as death approaches* Weak and irregular pulse death is about to happen
Strong pulse death is hours away
Body System Begins to Fail
Metabolism Metabolic rate decreases or stops Involuntary leakage of urine and/or feces
Urinary System Output decreases Blood pressure is too low for kidneys to filter properly Creates additional load on the heart
Nervous System Decreased oxygen to the brain Loss of sensation in legs and arms Can be conscious, semi-conscious, or comatose