Министерство здравоохранения Ростовской области

Государственное бюджетное профессиональное образовательное учреждение

Ростовской области

«Сальский медицинский техникум»

РАБОЧАЯ ТЕТРАДЬ

ПО ДИСЦИПЛИНЕ ОГСЭ.03 ИНОСТРАННЫЙ ЯЗЫК

(АНГЛИЙСКИЙ)

ДЛЯ ВНЕАУДИТОРНОЙ РАБОТЫ СТУДЕНТАМ

ПО СПЕЦИАЛЬНОСТИ СРЕДНЕГО ПРОФЕССИОНАЛЬНОГО ОБРАЗОВАНИЯ

34.02.01 СЕСТРИНСКОЕ ДЕЛО

БАЗОВОЙ ПОДГОТОВКИ

Студентки (та) ___ курса

группы______________________

Ф.И.О_______________________

_____________________________

__________________________________

Сальск

2024 г

1

РАССМОТРЕНО

УТВЕРЖДАЮ

на заседании цикловой комиссии И.о директора ГБПОУРО

общеобразовательных, ________________/И.В.Репкина

общих гуманитарных, социально-

-экономических, математических и «31

» августа

2024 года

общих естественнонаучных дисциплин

протокол №

1

от «31

» августа

2024 года

Председатель ЦК: ________ Сорокина С.И.

СОГЛАСОВАНО

Методист ГБПОУ РО «СМТ»

__________ / Е.А.Хижнякова

«31

» августа

2024 года

Рабочая тетрадь рекомендуется для использования на внеаудиторных занятиях по

дисциплине ОГСЭ.03 Иностранный язык (Английского языка) студентам медицинских

колледжей и техникумов, обучающихся по специальности 34.02.01 «Сестринского дело».

В содержание рабочей тетради входят требования ФГОС, перечень компетенций и

изучаемых вопросов, задания для актуализации опорных знаний, задания для закрепления

знаний и тестовые задания.

Предназначена рабочая тетрадь для студентов медицинских колледжей и техникумов.

© ГБПОУ РО «Сальский медицинский техникум», 2024 г.

Авторы: Кагальницская Л.С., преподаватель английского языка

ГБПОУ РО «Сальский медицинский техникум»,

Панащатенко С.Ф.- преподаватель высшей квалификационной категории

ГБПОУ РО «Сальский медицинский техникум»,

Рецензент: Стадник Ю.Н.- преподаватель иностранного языка (английский)

ГБПОУ РО СИТ

2

ОГЛАВЛЕНИЕ

ПОЯСНИТЕЛЬНАЯ ЗАПИСКА………………………………………………4

ИМЯ СУЩЕСТВИТЕЛЬНОЕ…………………………………………………..6

ГЛАГОЛ…………………………………………………………………………10

МЕСТОИМЕНИЕ……………………………………………………………….13

ТИПЫ ПРЕДЛОЖЕНИЙ В АНГЛИЙСКОМ ЯЗЫКЕ……………………….14

ГЕРУНДИЙ………………………………………………………………………26

ИМЯ ПРИЛАГАТЕЛЬНОЕ……………………………………………………..30

ВОПРОСЫ В АНГЛИЙСКОМ ЯЗЫКЕ………………………………………..32

ИМЯ ЧИСЛИТЕЛЬНОЕ………………………………………………………...35

ПРИЛОЖЕНИЕ………………………………………………………………….39

СПИСОК ИСПОЛЬЗОВАННОЙ ЛИТЕРАТУРЫ……………………………..57

3

Пояснительная записка

Рабочая тетрадь составлена в соответствии с программой дисциплины

ОГСЭ.03 Иностранный язык (английский) в соответствии с требованиями

Государственного образовательного стандарта для студентов медицинских

колледжей и училищ, обучающихся специальности «Сестринское дело»

Рабочая

тетрадь

предназначена

для

организации

внеаудиторной

самостоятельной работы студентов, которая способствует формированию их

познавательной активности, значительного интереса к изучаемому предмету и

лучшему

усвоению

профессиональных

знаний.

Тетрадь

может

быть

использована для контроля знаний на практических занятиях. Данное пособие

разработано с учетом того, что:

- усвоению учебного материала препятствует недостаточная школьная

подготовка

у

многих

студентов

и

низкая

эффективность

усвоения

грамматических моделей иностранного языка;

- за отведенное количество аудиторных часов преподаватель может лишь

нацелить

студентов,

обозначить

приоритетные

направления

и

дать

консультацию. Многое зависит от самостоятельной работы студентов.

Данное пособие направлено на систематическую работу, учебный материал

распределен в нем по темам.

Пособие отражает современные тенденции и соответствует требованиям к

обучению практическому владению иностранными языками в повседневном

общении и в профессиональной сфере деятельности будущих специалистов.

Характер

языкового

материала

и

темы

упражнений

определяются

следующими концептуальными положениями:

1. Владение английским языком является обязательным компонентом

профессиональной подготовки современного специалиста.

2. Курс среднего профессионального образования продолжает школьный

курс.

4

3.

Данный

курс

иностранного

языка

носит

коммуникативно

ориентированный характер. Его задачи определяются коммуникативными и

познавательными потребностями учащихся.

Цель пособия – способствовать повышению общей, коммуникативной и

профессиональной компетенции студентов.

В соответствии с социальным заказом государства основной целью курса

является

обучение

практическому

владению

разговорно-бытовой

речью,

языком специальности, умению извлекать информацию из современных

информационных источников.

Данное пособие ставит также образовательные и воспитательные задачи.

Достижение образовательной цели означает расширение кругозора студентов,

повышение уровня их общей культуры и образования, а также культуры

мышления, общения и речи. Воспитательный потенциал предмета реализуется

путем формирования уважительного отношения к духовным ценностям культур

других стран и народов.

5

Составные части языка

Фонетика

звуки, интонация, ритм

Лексика

словарный состав языка

Грамматика

структурные связи

Знаменательные

- имя существительное

- имя прилагательное

- числительное

- глагол

- наречие

- модальные слова

- местоимение

Служебные

- артикль

- предлог

- союз

- частица

The Noun. The Case of Nouns

Имя существительное. Падежи имен существительных

Active vocabulary

Parts of the body

Head and face:

eye – глаз

hair – волосы

nose – нос

ear – ухо

mouth - рот

lip – губа

neck – шея

tooth (teeth) – зуб (зубы)

tongue - язык

6

Морфология

части речи

Синтаксис

словосочетания, предложения

Arm and leg:

shoulder – плечо

nail – ноготь

arm – рука

finger – палец

hand – кисть, thumb – большой палец

leg – нога

knee – колено

foot (feet) – стопа (стопы)

toe – палец на ноге.

Rest of body:

chest (bust) – грудь

skin – кожа

side – бок

stomach – живот

back – спина

waist – талия

hip - бедро

Inside the body:

heart – сердце

brain – мозг

blood - кровь

Practice

1. Закончите предложения, используя слова из списка:

A hand has five _____.

A foot has five _____.

An adult has 32 _____.

You smile with your _____.

You smell with your _____.

The _____ is a symbol of love.

You hear with your _____.

You talk with your _____.

Your _____ type can be 0 (I), A (II), B (III) or AB (IV).

7

2. Слова, обозначающие части тела, могут употребляться в переносном

значении. Закончите предложения, пользуясь словами из списка: mountain,

clock, bottle, arm-chair.

A _____ has arms, legs and a back.

A _____ has a face and hands.

A _____ has its foot.

Word building

Соедините корни из колонок, чтобы получились сложные существительные и

переведите их:

foot stick

hair chair

arm ball

hand brush

lip bag

Обратите внимание на способы образования новых слов и ответьте на

вопросы:

а) Каким способом образованы следующие слова? Из каких элементов они

состоят?

headache – головная боль,

football – футбол.

Определите состав сложных слов и переведите их:

newspaper, textbook, homework, volley-ball, note-book.

б) От каких слов образованы следующие слова:

writer – писатель

reader – читатель

8

to rewrite – переписать

to re-read – перечитать

Переведите слова по словообразующим элементам:

doctor, teacher, worker, helper, professor, to reexamine, to replace, to rename, to

reconstruct, to redo.

в) Как называется такое явление? Переведите слова и определите часть речи

этих слов:

to work – the work

to help – the help

to act – the act

Образуйте

существительные

согласно

модели

и

переведите

пары

существительных:

N – noun – существительное,

V – verb – глагол,

A – adverb – прилагательное.

N+ship – friend + ship = friendship

relation, partner, member

N+hood – child + hood = childhood

mother, neighbour, brother

V+er – read + er = reader

to drive, to work, to play

A+ness – mad + ness = madness

dark, happy, ready

A+ity – public + ity = publicity

active, creative, noble

The Case of Nouns

Падеж

common case

(общий падеж)

genitive case

(притяжательный падеж)

shop, dog, man, family

the room of the sister – my sister’s room

idea, house, sister

the son of my friend – my friend’s son

9

Употребляется с одушевленными существительными; указывает, что

слово нужно переводить в родительном падеже.

Запомните:

Обратите

внимание:

Переведите на русский язык:

Ann’s table, this man’s book, the boy’s bag, the women’s pens, the boys’ books.

To be in the Present Simple Tense form

Изучите таблицу спряжения глагола to be в Present Simple. Ответьте на

вопросы:

1) Как изменяется глагол to be?

2) Как образуются отрицательная и вопросительная формы?

Practice

1. Вставьте глагол to be в соответствующем времени, лице и числе:

1) I _____ a medical student now.

2) Soon we _____ nurses.

3) My sister _____ ill. She _____ in the hospital now.

4) We _____ pupils last year.

5) They _____ teachers.

10

При переводе меняется порядок слов

The girls’ room is good.

Но:

The children’s room is good.

2. Поставьте следующие предложения в отрицательную и

вопросительную формы:

1) They were in Moscow.

2) He will be in France.

3) She is an engineer.

4) I am on holiday now.

По таблице спряжений группы Indefinite

изучите спряжение глаголов.

Обратите внимание на:

а)

окончания

смысловых

глаголов

в

Present

и

Past

Indefinite

и

на

вспомогательные глаголы в Future Indefinite в утвердительной форме;

б) появление в отрицательной форме вспомогательного глагола do и изменение

его в Present и Past на место частицы not;

в) форму смыслового глагола;

г)

место

вспомогательных

глаголов

в

вопросительной

форме

и

на

неизменяемость смыслового глагола;

д) краткие ответы.

Прослушайте, переведите и прочитайте.

Bad Habits

He sleeps a lot. Does he sleep much? Yes, a lot.

He drinks a lot. Does he drank much? Yes, a lot.

He smokes a lot. Does he smoke much? Yes, a lot.

He talks a lot. Does he talk much? Yes, a lot.

Does he eat much? Yes, a lot.

Does he read much? No, not much. Oh!

Дополните недостающие глаголы и инсценируйте диалог.

11

is, isn’t, are, aren’t, am, do, don’t, does, doesn’t, can, can’t

1. A: _____ you still need this dictionary?

B: No, I _____.

A: _____ I have a moment, then?

B: Sure.

2. A: _____ your new flat very big?

B: No, not very, but it _____ comfortable.

3. A: Ruth speaks Russian. _____ she?

B: Yes, she _____ and her Russian _____ good.

4. A: _____ I help you?

B: Yes, please. _____ I speak to Mr. Reston?

A: I _____ sorry. Mr. Reston _____ in at the moment.

5. A: Excuse me _____ you very busy at the moment?

B: No, not very _____ come in!

6. A: _____ you remember me?

B: Yes, I _____. You _____ Peter Todd. _____ you?

A: Yes, I _____.

Прочитайте и заучите наизусть, обращая внимание на употребление

вспомогательных глаголов.

In class.

Are the students here?

Yes, they are.

Is the teacher here?

12

Yes, she is.

Does she speak English?

Yes, she does.

Do they speak English?

Yes, they do, a little.

Has she got the textbook?

Yes, she has.

Have they got the textbooks?

Yes, they have.

Can they understand the teacher?

Yes, they can.

Can she understand them?

Yes, she can, sometimes.

The Pronoun

Местоимение

В следующих колонках обратите внимание на выделенные местоимения и

ответьте на вопросы.

I am here All know me All know my work

He is here All know him All know his work

She is here All know her All know her work

It is here All know it All know its work

We are here All know us All know our work

You are here All know you All know your work

They are here All know them All know their work

1. Как называются местоимения в каждой из колонок?

2. На какие вопросы они отвечают, и какими членами предложения являются?

13

Imperative

Повелительное наклонение

В английском языке просьба, приказ выражаются следующим образом:

Предложения начинаются с глагола-сказуемого в форме инфинитива без to:

Go to the doctor. Give a tablet.

Отрицательная форма образуется с помощью don’t:

Don’t open the window.

Если действие планируется совместно с говорящим:

Let’s do it together.

Practice

Прослушайте, переведите и прочитайте:

Let’s Meet Ted

Let’s meet Ted.

Yes, let’s.

Let’s meet Ed.

Yes, let’s.

Let’s meet Eve.

Yes, let’s.

Let’s meet Steve.

Yes, let’s.

Let’s see Nell.

Yes, let’s.

Let’s see Bell.

Yes, let’s.

Let’s see Eve.

Yes, let’s.

Let’s see Steve.

Yes, let’s.

Прослушайте, переведите и прочитайте:

Let’s leave soon so as not to miss the plane.

Let’s leave soon so as not to miss the train.

Let’s go now so as not to miss the bus.

14

Let’s go now so as not to miss the class.

Скажите по-английски:

1. Возьмите ампулы с витамином В.

2. Примите 2 столовые ложки теплого отвара.

3. Взболтайте микстуру перед употреблением.

4. Примите эти капли с молоком.

5. Дайте рецепт, пожалуйста.

6. Выпишите лекарство от головной боли.

7. Храните свечи и растворы в темном и прохладном месте.

8. Не принимайте эти порошки на голодный желудок.

9. Продолжайте внутривенное введение.

10. Промойте желудок больному немедленно.

11. Не курите!

Запомните пословицы:

Don’t cross the bridge before you come to it. – Наперед не загадывай.

Leave and learn. – Век живи, век учись.

Never put off till tomorrow what you can do today. – Не откладывай на завтра то,

что можешь сделать сегодня.

There is / There are Impersonal Statements

Безличные, неопределенно-личные предложения

There

is

/

There

are

–

обстоятельный

оборот,

указывающий

на

местонахождение лица или предмета в определенном месте. Эта конструкция

употребляется, когда мы сообщаем слушающему о предметах, неизвестных

ему. На русский язык эту конструкцию переводят «есть», «находиться».

Practice

15

Переведите следующие предложения:

1. There are two terms in the academic year.

2. There will be a meeting at the Institute.

3. There is a hostel near our Institute.

4. There was no medical article the yesterday’s newspaper.

Прослушайте, переведите и прочитайте:

Is There a Post Office Near Here?

- Is there a Post office near here?

- Yes, there is. Cross the road and turn right.

- Thanks a lot.

- Is there a snack bar near here?

- Yes, there is. Cross the road and turn left.

- Thanks a lot!

- Not at all.

- Is there a bus stop near here?

- Yes, there is. First left, second right.

- You can’t miss it. Thanks a lot!

- That’s all right.

Выучите пословицу:

While there is life there is hope. – Пока дышу, надеюсь.

Impersonal Statements

Безличные предложения

16

На русский язык безличные предложения переводятся как неопределенно-

личные: Тепло. Поздно. Интересно и т. д.

Practice

Ответьте на вопросы, используя слова из списка: sunny, warm, cold, cool,

snowing, hot, raining, cloudy.

How’s the weather in the winter? It is _____ .

How’s the weather in the fall? It is _____ .

How’s the weather in the summer? It is _____ .

How’s the weather in the spring? It is _____ .

Переведите предложения:

1. It is known that the increase of the number of leucocytes takes place when a

person is ill.

2. It is determined that in the man the corpuscles form from 39 to 50 percent of the

blood volume.

3. It is considered that heart sounds are very important in making the diagnosis of a

heart disease.

The Simple Sentence. Parts of the Simple Sentence.

Простое предложение. Части простого предложения.

Как и в русском языке, в английском выделяют пять членов предложения:

подлежащее, сказуемое (главные), дополнение, определение, обстоятельство

(второстепенные). В отличие от русского, в английском языке порядок слов в

предложении фиксированный.

17

Подлежащее

Subject

сказуемое

predicate

дополнение

object

обстоятельство

adverbial????

I work as a nurse at a hospital.

Practice

1.

В

следующих

предложениях

определите

члены

предложения

и

разместите их по графам таблицы.

1) My friend gets a stipend at the end of a month.

2) He’s brother was ill yesterday.

3) I shall see the doctor tomorrow.

2. Сделайте разбор по членам предложения и ответьте на вопросы:

The teacher asks the student at the lesson.

The student asks the teacher at the lesson.

1. Чем отличаются эти предложения друг от друга? Влияет ли порядок слов на

смысл английского предложения?

2.

На

каком

месте

стоит

подлежащее?

Сказуемое?

Дополнение?

Обстоятельство?

Запомните пословицу:

An apple a day keeps the doctor away. – Ешь по яблоку в день, и врач не

понадобится.

Present and Past

Настоящее и прошедшее время

I have got – I had

He says – he said

They go – they went

We spend – we spent

I write – I wrote

I drive – I drove

She leaves – she left

She keeps – she kept

18

They sell – they sold

They tell – they told

I teach – I taught

I think – I thought

Прослушайте, переведите и прочитайте:

When Did She Come?

When did she come?

She came at seven.

When did she leave?

She left at eleven.

When did they start?

They started at five.

When did they finish?

They finished at nine.

What did you buy?

I bought a new hat.

What did they bring?

They brought a stray cat.

It was very small. Now it’s big.

Where Did They Go?

Where did they go?

They went to the theatre.

What did they see?

They saw a new play.

How did they like it?

Oh, they enjoyed it.

We must all go and see it, they say.

Определите время сказуемого в следующих предложениях:

1. Present Indefinite

2. Past Indefinite

3. Future Indefinite

1) His sister studies at school.

2) You will see him tomorrow.

3) I went to the college at 7 o’clock.

4) Who took my book?

19

5) They work every day.

6) I shall read this book next week.

Прочитайте и переведите вопросы к подлежащему в Present

и Past

Simple:

A.

1. “Who likes coffee with milk?” “I do”

2. “Who knows that girl?” “He does”

3. “Who needs that cassette?” “We do”

4. “Who left that message?” “Mr. Clark”

5. “Who come first, Bob or Ted?” “Ted”

B.

1. “Which of you speaks English?” “Ann does”

2. “Which of you speaks French?” “I do”

3. “Which of you like animals?” “We all do”

4. “Which of them plays the piano?” “Lucy”

5. “Which of them helped you?” “Miss Ellis”

Переделайте 1-е и 3-е предложения в Past Indefinite, а 2-е и 4-е – во

Future Indefinite:

1. Many students want to join the Foreign Language Society.

2. My friend always helps me in Anatomy.

3. He does not study French as he studies English.

4. Medical students study many subjects.

Выучите пословицу:

Never say die. – Не вешай нос.

The Present Simple Tense or the Present Continuous Tense

Настоящее неопределенное или настоящее продолженное

20

1. Заполните пропуски в формулировке следующего правила:

Утвердительная форма the Present Simple Tense образуется с помощью

_____ . Вопросительная форма the Present Simple Tense образуется с помощью

форм

вспомогательного

глагола

_____

и

_____

смыслового

глагола.

Отрицательная форма the Present Simple Tense образуется с помощью форм

вспомогательного

глагола

_____

и

_____

смыслового

глагола.

Форма

вспомогательного глагола _____ употребляется, если подлежащее находится в

3-ем лице единственного числа.

He Loves the Internet

Alex Dale can’t keep a pet because he’s too busy.

He gets up at half past six (that isn’t very easy).

He gets home at ten o’clock, then eats and goes to bed.

He hates noisy parties.

He loves the Internet.

2. Заполните пропуски в формулировке следующего правила:

Утвердительная форма

the

Present

Continuous

Tense

образуется с

помощью форм вспомогательного глагола _____ и _____ смыслового глагола.

Вопросительная форма the Present Continuous Tense образуется с помощью

форм вспомогательного глагола _____ и _____ смыслового глагола, при этом

_____ ставится перед подлежащим. Отрицательная форма

the

Present

Continuous Tense образуется с помощью форм вспомогательного глагола _____

и _____ смыслового глагола.

Practice

Прочитайте диалоги и заполните пропуски, используя слова в скобках:

21

1. A: How good is your English?

B: Not bad. It _____ (get) better slowly.

2. A: Where _____ (you and your family / usually spend) the holidays?

B: Oh, we _____ (always / go) to France.

3. A: Which _____ (you / prefer), doing sport or playing computer games?

B: Neither. I _____ (usually / listen to) music in my spare time. But my brother

_____ (love) playing football.

Прочитайте и переведите:

What’s Going On?

What are you doing?

I’m watching the telly.

What’s Ben doing?

He’s talking to Kelly.

What’s Ann doing?

She’s taking a shower.

What’s Ted doing?

He’s watering the flowers.

What are you doing?

We’re having a talk.

What are they doing?

They are taking a walk.

The Present Perfect Tense or the Past Simple Tense

Настоящее завершенное и прошедшее неопределенное

Выбор между Present Perfect и Past Simple зависит от того, связано ли

действие, свершившееся в прошлом, с настоящим моментом или нет.

Present

Perfect

не

употребляется с обозначениями истекшего периода

времени: yesterday, a minute ago, last month.

Сравните:

Present Perfect

A: I have finished the test.

B: Have you? Good.

A: I have not read he’s new book yet.

B: Neither have I.

Past Simple

A: I finished it fifteen minutes ago.

B: Oh, did you?

22

A: I really his other books.

B: So did I.

Прослушайте, переведите и прочитайте.

Ann Has Been to London Three Times.

Ann’s been to London three times.

She’s been to Paris twice.

She’s met a lot of people there.

She finds them very nice.

She writes a lot of letters.

She gets a lot of calls.

She’s got a lot of friends abroad.

She says she likes them all.

Выучите стихотворение наизусть. Объясните употребление Past Simple,

Present Perfect:

Pussy Cat, Pussy Cat,

Where have you been?

“I’ve been to London

To look at the Queen”.

Pussy Cat, Pussy Cat,

What did you see there?

“I saw a little mouse

Under her chair”.

Practice

Работайте с партнером. Прочитайте следующие диалоги.

- What’s the matter with you?

- I have a toothache.

- I’m sorry to hear that. What happened?

- I ate candies all day yesterday.

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* * *

- What’s the matter with you?

- I have a backache.

- I’m sorry to hear that. What happened?

- I practiced shaping all day yesterday.

Переведите предложения, обращая внимание на использование Past

Indefinite и Past Perfect:

1. Исследователь закончил свои наблюдения на прошлой недели.

2. Мы узнали, что исследователь уже закончил свои наблюдения.

* * *

1. Врач изолировал больного до того, как он поставил диагноз инфекционного

заболевания.

2. Врач изолировал больного на прошлой неделе.

Modal Verbs

Модальные глаголы

Обратите внимание на значение и употребление модальных глаголов

“can”, “may”, “must”. Ответьте на вопросы:

I can speak English.

We can go to Moscow.

You may take this book.

He must come today.

Я могу (умею) говорить по-английски.

Мы можем (в состоянии) поехать в Москву.

Вы можете (вам разрешается) взять эту книгу.

Он должен (обязан) прийти сегодня.

1. Как переводятся модальные глаголы “can”, “may”, “must”?

2. Могут ли они употребляться самостоятельно или только в сочетании с

другими глаголами?

3. В какой форме стоят смысловые глаголы после модальных?

4. Изменяются ли модальные глаголы по лицам и числам?

24

5. Как образуется отрицательная и вопросительная формы?

Поставьте предложения в утвердительной форме:

1. Must the students work much during the whole term?

2. He could not enter the Institute last year.

3. Can he become a good therapeutist?

4. May this remedy do you any harm?

Practice

1. Работайте с партнером. Расспросите партнера о том, что он может и

чего не может делать, используя идиомы, слова и выражения из следующей

таблицы:

Model: Can you swim? – Yes, I can. / No I can’t.

I can drive, but I can’t fly a plane.

I

Play any musical instruments

the guitar, piano, saxophone

II

Speak any foreign language

French, English, Italian

III

Play the games, do activities

baseball, football, tennis

IV Use

a computer, vacuum, cleaner, mobile phone

V

Others

explain the theory of relativity, recite poetry

Представьте, что вы медицинский работник со стажем. Объясните

вновь принятому работнику, что он должен (обязан) делать и что не должен.

You must:

__________

__________

__________

You mustn’t:

__________

__________

__________

Выучите пословицу:

A man can die but once. – Двум смертям не бывать, а одной не миновать.

25

Переведите предложения, обращая внимание на модальные глаголы.

1) В колледже вы должны получить глубокие знания по медицине.

2) Можно мне посетить вашу лекцию?

3) Вы можете (в состоянии) легко выполнить это задание?

4) Мы должны закончить работу в 6 часов.

5) Медсестра должна быть особенно внимательна к лежачим больным.

The Gerund

Герундий

1. Герундий – это название действия, в котором сочетаются свойства, как

глагола, так и существительного.

2. Герундий образуется из основы глагола + окончания ing

write + ing = writing, read + ing = reading.

3. Герундий, наряду с инфинитивом употребляется после глаголов like и love.

I like reading.

Jane loves dancing.

Я люблю читать.

Джейн любит танцевать.

4. Герундий – единственный (и очень удобный) способ назвать действие после

предлога:

Thank you for coming.

She is good at explaining difficult

things.

Спасибо, что пришли.

Она хорошо объясняет сложные

понятия.

Practice

Повторите, употребляя подсказанные слова:

1. Thank you for coming.

calling; writing to us; visiting us; helping us.

2. Sorry for being late.

calling so late; keeping your book; missing so many lessons.

3. I like skating.

26

sking; fishing; reading; listen to good music.

4. She is good at cooking.

making cakes; making films; taking photos; speaking to visitors.

Переведите:

1. Спасибо, что позвонили врачу.

2. Извините за опоздание на лекцию.

3. Мне нравится помогать сидячим больным.

4. Аня любит делать внутривенные инъекции.

5. Спасибо, что пришли к больному так быстро.

Закончите предложения, употребляя герундий.

1. When did you finish

discuss your plans?

do your homework?

clean the flat?

read that book?

2. We enjoyed

3. He kept

go to a rock concert.

go to a disco.

take long walks.

make the same mistakes.

repeat the same thing.

ask questions.

Закончите предложения, выражая свою точку зрения:

1. I’m really interested in _____ .

2. I’ m looking forward to _____ .

3. _____ is something that makes me nervous.

27

4. _____ is one of my favorite things to do at the weekend.

Замените инфинитивы, данные в скобках, герундием.

1. After the recovery the patient stopped (to lose) his weight.

2. My brother had to give up (to smoke) due to chronic bronchitis.

3. The young physician tried (to introduce) various new ways of treatment.

4. You must avoid (to catch) a cold as you have just been ill with pneumonia.

5. What has perverted you from (to attend) this lecture?

Запомните:

функции герундия в предложении.

1. Подлежащее

Smoking is not allowed.

Курить не разрешается.

2. Именная часть составного сказуемого

Abortion is removing of the fetus.

Аборт – это удаление плода.

3. Дополнение

He knew of my studying in the medical

college.

Он знал о моей учебе в медицинском

колледже.

4. Определение

There are different methods of treating

this disease.

Существуют

различные

способы

лечения этого заболевания.

5. Обстоятельство

After receiving necessary information

we can perform the operation.

Получив необходимые данные, мы

можем сделать операцию.

Таким образом, герундий может переводиться как существительное,

инфинитив, деепричастие, придаточное предложение.

The passive Voice

Пассивный залог

Образование: to be + V

3

(Past Participle)

The Active Voice

I asked

28

He asked

She asked

The Passive Voice

I was asked

He was asked

We were asked

Прочтите предложения и ответьте на вопросы:

1. В каком времени и в какой форме стоит сказуемое в левой колонке и как

переводятся эти предложения?

2. Из чего состоит сказуемое в колонке справа? Переведите предложения. Дайте

форму страдательного залога.

3. Что изменяется в этой формуле при изменении по временам, лицам и

числам?

4. Что остается неизменным в этой формуле?

5. Поставьте глагол to be в нужной форме для образования Present и Future

Indefinite Passive.

6. Как образуются отрицательные и вопросительные формы в страдательном

залоге?

Practice

I Переведите предложения:

1. These operations are performed by me.

2. Medical students are taught Anatomy in practical class.

3. The lecture in Biology is delivered on Monday.

II Найдите предложения, которые стоят в страдательном залоге:

1. This text-book is experimental.

2. Many experiments are carried out by students.

3. He is happy because he studies at the Medical Institute.

4. I am given lesson in many subjects.

5. Anatomy is taught at the Medical Institute.

Переведите предложения:

29

1. Нам дают книги.

2. Меня часто спрашивают.

3. Операции проводятся хирургом.

4. Учебники пишутся для студентов.

5. Нас часто видят в библиотеке.

Прослушайте, переведите и прочитайте:

It’s Not My Fault!

I’m terrible sorry, but it wasn’t my fault.

I wasn’t asked, I wasn’t told.

I wasn’t asked to do that job.

I wasn’t asked to wait for Bob.

I wasn’t told to call you back.

I wasn’t told to stay and help.

I wasn’t asked to come today.

I wasn’t asked! I’m not to blame.

fault – вина

blame – винить

It’s not my fault

I am not to blame

Я не виноват.

The Adjective. Degrees of Comparison

Прилагательное. Степени сравнения имен прилагательных

Степень

Положительная

Positive

Сравнительная

Comparative

Превосходная

Superlative

Форма

синтетическая

- er, - est

clean

hot

happy

cleaner

hotter

happier

the cleanest

the hottest

the happiest

аналитическая

comfortable

difficult

more comfortable

more difficult

most comfortable

most difficult

Нерегулярные степени сравнения

good – better – best

bad – worse – worst

30

little – less – least

much / many – more – most

Practice

I. Образуйте степени сравнения от следующих прилагательных и

наречий:

well, responsible, deep, happy, high, early, great, new, easy, much, clear, interesting.

При помощи каких слов сравниваются одинаковые по качеству прилагательные

в английском языке?

1. Her article is as interesting as his.

2. Her article is not so interesting as

his.

Ее статья такая же интересная, как

его.

Ее статья не такая интересная, как

его.

II. Определите каким способом происходит сравнение в предложениях и

переведите их.

1. I am as tired as he is.

2. You must be more responsible for your work.

3. He knows Latin worse than his friend does.

4. Solomin’s knowledge of Anatomy is not so deep as Petrovs.

5. They came to the Institute earlier than usual.

III. Переведите предложения

1. Бакерия – один из самых известных хирургов в мире.

2. Студент Попов сделал работу быстрее, чем студент Иванов.

3. Чем больше вы работаете, тем легче сдавать экзамены.

4. Его работа лучше вашей, но работа Анны – самая лучшая.

5. Я живу не так далеко от института, как мой друг.

31

6. «Скажите, этот доктор более опытный, чем тот?» - «Все наши врачи имеют

высшую категорию».

Прочитайте и переведите:

Which is Bigger?

Which is bigger, France or England?

Which is smaller, Holland or Finland?

Which is larger, London or Glasgow?

Which is smaller, Leeds or Moscow?

France is bigger than England.

Holland is smaller than Finland.

London is larger than Glasgow.

Leeds is smaller than Moscow.

Why Study?

The more we study, the more we know. The more we know, the more we forget.

The more we forget, the less we know. The less we know, the less we forget. The less

we forget, the more we know. So why we study?

Вопросы в английском языке

Вопросы бывают четырех типов: общие, специальные, альтернативные и

разделительные.

Общие вопросы.

Общими вопросами называются такие вопросы, на которые можно

ответить да (yes) или нет (no). Такие вопросы начинаются с вспомогательного

глагола.

Do you study anatomy in college? Yes, I do.

Специальные вопросы.

32

С помощью специальных вопросов выясняется какой-либо факт или

обстоятельство. Они относятся к одному из членов предложения и начинаются

с вопросительного слова.

Where do you study? I study at the Balashov medical college.

Альтернативные вопросы.

Альтернативные вопросы предполагают выбор одного из двух возможных

вариантов и требуют полного ответа.

Do you study Latin or Surgery in the first year? We study Latin in the first year.

Разделительные вопросы.

Цель разделительного вопроса состоит в уточнении того или иного факта

или обстоятельства. Эти вопросы требуют полного ответа.

You study English, don’t you? Yes, I study English.

You don’t study English, do you? No, I don’t study English.

Practice

I. Прочитайте предложения:

Does she speak English? Can you treat rheumatism? Did he prepare his laboratory

work yesterday? Must they attend this lecture?

Как называются такие вопросы, и какой в них порядок слов?

II. Проанализируйте следующие предложения, ответьте на вопросы:

Who studies anatomy? Who carried out laboratory analyses yesterday? Who will

prepare the article tomorrow?

1. Какие вопросы называются «специальными»?

2. К какому члену предложения заданы эти вопросы, и какой порядок слов

требуется построения таких вопросов?

Напишите вопросы к заданному предложению:

My friend carried out a valuable experiment at the laboratory last week.

33

III. Ответьте на альтернативные вопросы:

1. Does the term “aetiology” mean the causes of the disease or the mechanism of its

development?

2. Is reanalysis an instrumental or a laboratory study?

3. Are haemorrhage and vomiting subjective or objective symptoms?

4. Is a productive cough associated with the discharge of sputum or is it dry?

IV. Образуйте присоединенные вопросы:

1. Her name is Judy, _____ ?

2. We are students of the medical school _____ ?

3. We spoke about it at the last meeting, _____ ?

4. Petrov has got a new book, _____ ?

5. I have done a lot of work today, _____ ?

Прочитайте и переведите:

Too Many Questions.

Have you been there?

Have you seen it?

Have you bought it?

Have you brought it?

Have you read it?

Have you said it?

Has he heard it?

Has he learned it?

Have they used it?

Have they closed it?

Have you called him?

Have you told him?

Could you take a break, please?

I can’t answer so many questions at once!

Computer Crazy

I haven’t done my homework.

I haven’t read the text.

I haven’t learned the dialogues –

I need them for the test.

I haven’t read the paper.

I haven’t heard the news.

I haven’t left the house yet.

I have lost my new black shoes.

34

You may think I am crazy.

Don’t think so, wait a bit.

I have bought a new computer game.

I can’t stop playing it.

The Numerals

Имя числительное

Именем числительным называется часть речи, обозначающая количество

или порядок предметов. Имена числительные делятся на количественные,

отвечающие на вопрос сколько?

и порядковые, отвечающие на вопрос

который?

Practice

Работайте с партнером. Задайте ему эти вопросы, затем поменяйтесь

ролями.

1. When were you born?

2. What is your height and weight?

3. What is your address?

4. What is the population of your town?

5. What is the population of Russia?

Заполните заявление на работу

Job Application

____________________________________________________________________

Name _______________________________________________________________

Last First Middle

Country of current citizenship ____________________________________________

Gender Male / Female

Date of birth __________________

Address ______________________

Telephone ____________________ Fax _____________ E-male ________________

35

Marital status (single, married, widowed, divorced)

Age of children, if any __________

Date of school graduate _________

Academic degrees _____________________________________________________

Degree Date received

Current position _______________ since ____________

Previous position ______________ since ____________ till ____________________

Прослушайте, переведите и прочитайте:

See Me at Seven.

See me at seven.

See me at seven.

See me at five.

See me at nine.

Fine.

See Nell at seven.

See Bell at eleven.

See Ted at five.

See Ed at nine.

Fine.

Let’s Meet at Five.

Let’s meet at five.

Fine!

Let’s meet at nine.

Fine!

Let’s meet at seven.

Yes, let’s.

Let’s meet at eleven.

Yes, let’s.

Let’s meet at ten.

Yes, let’s.

Please tell Ben,

OK!

36

Прочитайте и переведите:

1. at five, at six, at seven, at nine, at ten.

2. Please see me at ten.

3. Let’s meet at five.

4. Let’s eat at six.

5. Let him see me at eleven.

6. Let Ted meet me at nine.

Попросите встретить вас:

A: Please meet me at five.

B: Fine.

Попросите повидаться с вами:

A. Please see me at five.

B. Fine.

at 7; at 9; at 6; at 8; at 11.

Прослушайте, переведите и прочитайте:

“Fifty?” “No, Fifteen”.

1. Fifty? No, fifteen.

Sixty? No, sixteen.

Eighty? No, eighteen.

Ninety? No, nineteen.

Seventy? No, seventeen.

Oh, I see.

2. 15 teams? No, 50 teams.

16 films? No, 60 films.

18 lists? No, 80 lists.

19 tests? No, 90 tests.

37

Oh?

Разыграйте диалог, меняя время встречи.

A. Let’s meet at five.

B. At five? Let me see… Let’s meet at five fifteen.

A. Fine, only don’t be late.

6.00-6.15; 7.00-7-15; 8.00-8.15; 9.00-9.15; 10.00-10.15; 11.00-11.15; 12.00-12.15.

Повторите, меняя время

It isn’t ten yet. It is only nine.

Yet – до сих пор, пока еще.

9.00-8.00; 8.00-7.00; 11.00-10.00; 7.15-7.00; 9.15-9.00; 6.15-6.00.

Повторите, меняя возраст

1. Bobby isn’t seven yet. He’s only six.

6-5; 8-7; 9-8; 11-10.

2. Bess isn’t sixteen yet. He’s only fifteen.

17-16; 18-17; 19-18.

3. He isn’t fifty-five yet. He’s only fifty.

56-55; 57-56; 59-58; 60-59.

38

Приложение

ТЕКСТЫ ДЛЯ САМОСТОЯТЕЛЬНОЙ РАБОТЫ (Basic Nursing:

Theory and Practice. Third Edition. P. Potter, A.G. Perry. Mosby-Year Book,

Inc., 1995. ТЕКСТ АДАПТИРОВАН И СОКРАЩЕН)

NURSING THEORIES. ROLES AND FUNCTIONS OF THE NURSE

The following sections describe, in chronological order, the general focus of

several important theories of the philosophy of nursing. A nursing curriculum will

often include one or more of these nursing theories as a part of its conceptual

framework (see Table SUMMARY OF NURSING THEORIES).

Peplau's Theory

Hildegard Peplau's theory (1952) focuses on interpersonal relationships

people form as they pass through developmental stages. Nursing's purpose is to

educate the client and family and help the client to reach mature personality

development (Chinn, Jacobs, 1991). Therefore the nurse develops a nurse-client

relationship in which the nurse is a resource person, counsellor, and surrogate.

39

When the client seeks help, the nurse discusses the nature of the problem and

explains the services available. As the nurse-client relationship develops, the nurse

helps the client to identify the problem and potential solutions. The client gains

from this relationship by using available services to meet needs. When the original

needs have been resolved, new needs may appear.

Abdellah's Theory

The nursing theory developed by Faye Abdellah et al. (1960) emphasises

delivering nursing care for the whole person to meet physical, emotional,

intellectual, social and spiritual needs. The nurse needs knowledge and skills in

interpersonal relations, psychology, growth and development, communication,

sociology, and the basic sciences, as well as specific nursing skills. The nurse, a

problem solver and decision maker, forms an individualised view of the client's

needs, which may occur in the following areas:

1. Comfort, hygiene, and safety

2. Physiological balance

3. Psychological and social factors

4. Sociological and community factors

In these areas, Abdellah et al. (1960) identify 21 specific client problems

(often referred to as "Abdellah's 21 nursing problems"), which emphasise the

physical (e.g., maintenance of elimination or sensory function) and psychological

needs (e.g., maintenance of effective verbal and non-verbal communication) of

each client. The nurse helps the client meet these needs by facilitating and

maintaining a healthy physical condition in the best therapeutic environment

possible. The nurse uses interpersonal skills, sound medical knowledge, and

community resources to provide individualised holistic care.

Henderson's Theory

Virginia Henderson's nursing theory involves basic needs of the whole

person. Henderson (1964a) defines nursing as:

assisting the individual sick or well in the performance of those activities

contributing to health or its recovery (or to a peaceful death) that he would

40

perform unaided if he had the necessary strength, will, or knowledge. And to do

this in such a way as to help him gain independence as rapidly as possible.

Henderson (1964) identifies specific needs, often called "Henderson's 14

basic needs," such as breathe normally, sleep, and rest. These emphasise

maintaining a safe, healthy way of living, associated with good hygiene, an active

social life, and personal development.

Orlando's Theory

To Ida Orlando (1961), the client is an individual with a need that, when met,

diminishes distress, increases adequacy, or enhances well-being (Chinn, Jacobs,

1991). Her theory focuses on nurses' reactions to client behaviour in terms of the

client's immediate need (Torres, 1986). Orlando's theory describes three elements

— client behaviour, nurse reaction, and nurse actions—that compose the nursing

situation (Marriner-Tomey, 1994). After nurses assess the client's needs, they

recognise the impact of that need on the client's level of health and then act

automatically or deliberately to meet the need. Nursing acts to reduce the client's

distress.

Johnson's Theory

Dorothy Johnson's theory of nursing (1968) focuses on how the client adapts

to illness and how actual or potential stress can affect the ability to adapt. For

Johnson the goal of nursing is to reduce stress so the client can move more easily

through the recovery process. Johnson's theory focuses on basic needs in terms of

the following categories or subsystems of behaviour:

1. Security-seeking behaviour

2. Nurturance-seeking behaviour

3. Mastery of oneself and one's environment according to internalized

standards of excellence

4. Taking nourishment in socially and culturally acceptable ways

5. Ridding the body of waste in socially and culturally acceptable ways

6. Sexual and role identity behaviour

7. Self-protective behaviour

41

The nurse assesses the client's needs in these categories. The client is able to

function fairly effectively in the environment under normal conditions. When

stress disrupts normal adaptation, however, behaviour becomes erratic and less

purposeful. The nurse identifies the inability to adapt and provides nursing care to

resolve problems in meeting the client's needs.

King's Theory

Imogene King's theory (1971,1981) also focuses on the interpersonal

relationship between the client and nurse. The nurse-client relationship is the

vehicle for the nursing process, a dynamic interpersonal process in which the nurse

and the client are affected by each other's behaviour and the health care system.

The nurse communicates to assist the client in re-establishing or maintaining a

positive adaptation to the environment.

Orem's Theory

Dorothea Orem's (1971) definition of nursing emphasises the self-care needs

of the client. Orem describes her philosophy of nursing as follows:

Nursing has as a special concern man's needs for self-care action and the

provision and management of it on a continuous basis in order to sustain life and

health, recover from disease or injury, and cope with their effects. Self-care is a

requirement of every person—man, woman, and child. When self-care is not

maintained, illness, disease, or death will occur. Nurses sometimes manage and

maintain required self-care continually for persons who are totally incapacitated.

In other instances, nurses help persons to maintain required self-care by

performing some but not all care measures, by supervising others who assist

patients, and by instructing and guiding individuals as they gradually move toward

self-care.

The goal of Orem's self-care deficit theory is helping the client achieve self-

care. Nursing care is necessary when the client is unable to fulfil biological,

psychological, developmental, or social needs. The nurse determines reasons a

client is unable to meet self-care needs, actions that will enable the client to meet

these needs, and client self-care abilities.

42

Neuman's Theory

Betty Neuman forms a total-person model by incorporating the holistic

concept and the open-system approach (Marriner-Tomey, 1994). Neuman views

the person as a dynamic composite of physiological, sociocultural, and

developmental variables functioning as an open system (Neuman and Young,

1972). Her goal of nursing is to assist individuals, families, and groups to attain

and maintain a maximal level of total wellness.

The nurse assesses, manages, and evaluates client systems and focuses on

factors affecting the client's response to stressors. Nursing actions are in one of the

following levels of prevention: primary, secondary, and tertiary. Primary

prevention strengthens a line of defence through identification of actual or

potential risk factors associated with stressors. Secondary prevention strengthens

internal defences and resources by establishing priorities and treatment plans for

identified needs. Tertiary prevention focuses on readaptation (Neuman, 1982).

Levine's Theory

Myra Levine's nursing theory (1973) views the client as an integrated being

who interacts with and adapts to the environment. Conservation of energy is a

primary concern. In this theory, health is viewed in terms of conservation of energy

in the following areas, which Levine calls the "four conservation principles of

nursing":

1. Conservation of client energy

2. Conservation of structural integrity

3. Conservation of personal integrity

4. Conservation of social integrity. With this approach, nursing care

involves conservation

With this approach, nursing care involves conservation activities aimed at

optimal use of client's resources.

Roles and Functions of the Nurse

A contemporary nurse possesses knowledge and skills in a variety of areas. In

the past, nurses provided care and comfort while they carried out specific nursing

43

functions, but changes in nursing have expanded the roles of nurses to include

health promotion, illness prevention, health restoration, and concern for the whole

client (see box above).

ROLES AND FUNCTIONS OF THE NURSE______________________

CARE GIVER

The nurse directly helps the client to regain health through the healing

process. The nurse addresses the holistic health care of the client, including helping

the client and family restore emotional and social well-being.

DECISION MAKER

The nurse, before taking any action, interprets available information and

decides the best approach for the individual client. These decisions can be made

alone, with the client and family, or with other health care professionals.

PROTECTOR AND CLIENT ADVOCATE

The nurse maintains a safe environment, helps prevent injury, and protects

the client from possible adverse effects related to treatment. The nurse also protects

the client's human and legal rights and assists him or her in asserting those rights if

the need arises.

44

MANAGER

The nurse delegates responsibility, supervises other health care workers,

manages the resources of the practice setting, and coordinates activities.

REHABILITATOR

The nurse assists the client's return to maximal functioning through teaching

and helping the client to cope with changes associated with illness or disability.

COMFORTER

The nurse cares for the client as a person through emotional support. The

client needs help in reaching therapeutic goals.

COMMUNICATOR

The nurse is continually involved in promoting communication among all

people affected by the client's' needs. Communication is critical in meeting the

needs of clients, families, and communities.

TEACHER

45

The nurse explains concepts and facts about health care to the client,

reinforces learning, and evaluates progress. Teaching is individualized and may be

formal or informal

Career Roles. Career roles are specific employment positions. Most skills re-

quired for the expanded roles of the 1980s and 1990s are taught in baccalaureate

nursing programs. These skills are now directed toward the generalist practitioner.

The newer requirements for nursing specialization are redefining the term

"expanded role" (Mechanic, 1988). Nursing specialties have input into the

educational requirements for these roles and career opportunities (see box at left).

One method of redesigning nursing roles has been the focus of differentiated

nursing practice. This practice had early design in the educational setting where

graduate-expected competencies were based on different types of educational

experiences. Differentiated practice is now expanding into clinical practice as new

nursing roles incorporate primary nursing and case management principles

(Harkness et al., 1992). Broadly defined, differentiated practice structures roles and

functions of nurses according to education, experience, and competence, while

recognizing the importance of all roles to create a community of professional

nursing practice (Koerner, 1992). For example, in such a system there is a clear

difference between the responsibilities of a baccalaureate-prepared nurse versus

one with an associate's degree.

CAREER ROLES____________________________

NURSE EDUCATOR

Nurse educators work in schools of nursing, staff development departments,

and client education departments. They provide educational programs for student

nurses and nurses and teach clients about self-care and home care. They usually are

required to have graduate nursing education.

CLINICAL NURSE SPECIALIST

Clinical nurse specialists work in critical, acute, long-term, and community

health care agencies (Figure 1-5). They often specialize in managing specific

46

diseases, and they function as clinicians, educators, managers, consultants, and

researchers. They have master's degrees in nursing.

NURSE PRACTITIONER

Nurse practitioners are certified to provide health care to clients, usually in

outpatient or community settings. Adult nurse practitioners provide primary care to

adults; family nurse practitioners provide primary care for families; pediatric nurse

practitioners provide care for infants and children; gerontology nurse practitioners

provide care to older adults; and obstetrics-gynecology nurse practitioners provide

primary care for women. Most have master's degrees in nursing.

CERTIFIED NURSE-MIDWIFE

Certified nurse-midwives are certified by the American College of Nurse-

Midwives to provide independent care for women during normal pregnancy, labor,

and delivery. They practice in conjunction with a health care agency, which

provides assistance.

NURSE ANESTHETIST

47

Nurse anesthetists are registered nurses who have advanced training in

anesthesiology. They provide surgical anesthesia under the supervision of an

anesthesiologist and administer anesthetics to clients during minor surgery.

NURSE ADMINISTRATOR

Nurse administrators manage client care within a health care agency. They

may hold middle-level (e.g., head nurse) or upper-level (e.g., director)

management positions. They usually have baccalaureate degrees in nursing and

may have master's degrees.

NURSE RESEARCHER

Nurse researchers investigate nursing problems to improve care and to define

and expand the scope of nursing practice. They may be in academic, independent,

or community settings. They must have a graduate degree in nursing. In some

settings, a doctoral degree is required

Health Care Team

In most practice settings, the nurse works with other health care professionals

to provide total care for clients (see box below). The involvement of many persons

in the client's health care can pose risks for fragmenting care. Because nurses have

the greatest opportunity to interact with all professionals in the health care team,

they often coordinate and integrate services within the care plan.

OTHER HEALTH CARE TEAM MEMBERS______________________

PHYSICIAN

A physician is a professional who has earned a degree of doctor of medicine

or doctor of osteopathy and has passed a licensing examination. Most physicians

specialize their practice of medicine. Nurses work closely with physicians under

supervision or as collaborators.

PHYSICIAN ASSISTANT

Physician assistants have medical training and work under the direction of

physicians in hospitals, clinics, and private offices (they do not practice in

Canada). Nurses work with them as they do with physicians.

THERAPIST

48

Therapists are licensed to assist in the examination and treatment of clients in

special ways (i.e., as physical, occupational, or respiratory therapists). Their

education varies but usually involves 4-year programs. Nurses collaborate with

them and evaluate their work.

PHARMACIST

Pharmacists are licensed to formulate and dispense drugs. They may have

bachelor of science degrees or doctorates in pharmacology. Pharmacists provide

valuable information to nurses about drugs and their use and effects.

SOCIAL WORKER

Social workers are trained to counsel and refer clients to appropriate

agencies. They have baccalaureate or master's degrees. Nurses work together with

them to identify the best resources for the client, particularly when the client

returns home.

CHAPLAIN

Chaplains offer spiritual support and guidance to clients and their families.

They may be employed by an agency or provided by a church in the community. A

client may request a chaplain, or a nurse may refer the client to one.

NURSING AS A PROFESSION

Professionalism

"Professionalism

of

nursing

will

be

achieved

only

through

the

professionalhood of its members" (Margarita Styles, 1982). Nursing is not simply a

collection of specific skills, and the nurse is not simply a person trained to perform

specific tasks. Nursing continues to evolve into a profession. No one factor

absolutely differentiates a job from a profession, but several characteristics are

basic to any true profession. Sociologists ranging from Flexner in 1900 to Caplow

in 1950, Etzioni in 1960, and Levenstein in 1985 have studied the characteristics of

professions. They agree that some core characteristics are true for any profession.

These include education, theoretical body of knowledge, the provision of a specific

service, the autonomy of members, and a code of ethics. Nursing clearly shares, to

49

some extent, each of these characteristics and faces controversial issues as nurses

strive for greater professionalism.

Education. An earlier section describes the three basic types of educational

preparation for registered nurses. As a profession, nursing requires that its

members possess a significant education, but the issue of educational

standardization is a major controversy in nursing today. Most nurses agree that

nursing education is of great importance to practice and that nursing education

along with continuing education must respond to the changes in health care created

by scientific and technological advances.

Theory. Nursing knowledge has been developed through nursing theories.

Theoretical models are frameworks for nursing curricula and clinical practice and

also lead to research that increases the scientific basis of nursing practice. A theory

is a way of understanding a reality, and, in this general sense, all practicing nurses

use theories they have learned as a part of their clinical practice. Theoretical

frameworks help nurses to understand the scope of their practice and to select

interventions most likely to assist clients to an improved state of health.

Service. Nursing, like other professions, provides a specific service. Today,

nursing is a vital part of the health care delivery system, providing holistic and

comprehensive services to clients with varying needs. Nurses are now the largest

group of professionals in this system. Approximately 2 million people are now

registered nurses, and one study indicates that approximately 80% of them are

employed (Aiken andMillinix, 1987).

Autonomy. Autonomy means that one is reasonably independent and self-

governing in decision making and practice. It has been difficult for nurses to attain

the degree of autonomy enjoyed by some other professionals. Some data suggest

that the history of nursing has been a struggle by nurses for autonomy in the face

of different societal expectations (Cohen, 1992). In the past, physicians, hospital

administrators, and others in the health care delivery system have found nursing

autonomy difficult to understand and support. Through clinical competence and

greater educational preparation, however, nurses are increasingly taking on

50

independent roles in nurse-run clinics, collaborative practice, and advanced nursing

careers. A 1992 nursing research study indicated a positive relationship between

the highest level of nursing education and the autonomy of nursing roles

(Schutzenhofer, 1992).

Greater responsibility and accountability come with increased autonomy. Ac-

countability means the nurse is answerable, professionally and legally, for the type

and quality of nursing care provided to clients. The nursing profession regulates

accountability through standards of practice, nurse practice acts, nursing audits,

and certification.

Code of Ethics. Nursing has had a code of ethics since 1903. The code of

ethics describes the goals and values of the nursing profession and establishes a

code of conduct by which nurses function. Ethical principles within the code

provide a foundation for nursing practice. In addition, nurses incorporate their own

values and ethics into their practice.

NURSING PROCESS

Historical perspective

Nursing has always been directed at serving the health care needs of society.

Nursing originated with the desire to keep people healthy and provide comfort,

care, and assurance to the ill. Nursing was distinguished in its early history as a

form of community service and was originally related to a strong instinct to

preserve and protect the family. Although the goals of nursing have remained

relatively the same over the centuries, its practice has been influenced by the

changing characteristics of society. Thus nursing has gradually evolved into a

modern profession.

Nursing is as old as medicine. Throughout history, nursing and medicine have

had an interdependent relationship. During the era of Hippocrates, medicine

practiced without nursing, and during the Middle Ages, nursing practiced without

rational medicine.

Many ancient societies did not value human life so the caretakers of life were

less respected. The nurse tended to the hygiene of clients in the home under the

51

direct supervision of a physician. Nurses did not participate in activities to promote

health nor did they teach families how to care for the ill.

Under the influence of Christianity, nurses gained respect, and the practice of

nursing expended. Although nursing became increasingly humanistic, there was

still no formal education or training for nurses.

The Sisters of Charity (1633) was founded by St. Vincent de Paul. The sisters

cared for people in hospitals, asylums, and poorhouses. The sisters also became

widely known as visiting nurses because they cared for sick people in their homes.

The first supervisor of the Sisters of Charity was Louise de Gras who established

perhaps the first educational program to be associated with a nursing order. The

program included experience in the hospital, home visits, and the care of the ill.

In the eighteenth century, the growth of cities

brought an increase in the number of hospitals and a

greater role for nurses.

In 1860 Florence Nightingale wrote Notes on

Nursing: What It Is and What It Is Not for the

layperson. Her philosophy of nursing practice

reflected the changing needs of society. She saw the

role of nursing as having "charge of somebody's

health" based on the knowledge of "how to put the

body in such a state to be free of disease or to

recovery from disease".

During the same year she developed the first organized program of training

for nurses, the Nightingale Training School for Nurses at St. Thomas Hospital in

London.

52

Modern definitions and philosophies of nursing

As nursing has evolved, expanding its roles and concepts, theorists have

defined nursing in many ways. Florence Nightingale addressed nursing as a

discipline in 1859 and believed that the nature of nursing knowledge was distinct

from medicine. Conceptual and theoretical nursing models provide knowledge to

improve practice, guide research and nursing curricula, and identify the goals of

nursing practice. Theory provides the nurse with goals for assessment, diagnosis,

and intervention. It also provides common ground for communication and for

professional autonomy and accountability. The following table describe the general

focus of important theories of the philosophy of nursing. A nursing curriculum will

often include one or more of these nursing theories as a part of its conceptual

framework.

The term nursing process was first introduced by Lydia Hall in 1955. In

1966 Virginia Henderson identified basic nursing actions as independent functions

and stated that the nursing process uses the same steps as the scientific method.

Since 1973, nursing educators and clinicians began to use the five-step process

model on a regular basis.

Nursing process is a systematic problem-solving method for providing

individualized care for clients in all states of health. The client is viewed as an

individual and a member of a social unit that includes the family and significant

53

others. The nurse includes the client and family and significant others in each step

of nursing care.

The nursing process has five interrelated steps: assessment, nursing diagnosis,

planning,

implementation

and

evaluation.

During

the

assessment

phase,

information about the client is gathered to identify client problems. The collected

information is analyzed, and specific client health care problems are stated during

the nursing diagnosis step. During the planning step, goals expected outcomes and

nursing care are planned with the client. Actual nursing care is delivered during the

implementation phase. The evaluation step allows the nurse and client to evaluate

the success of nursing care through achievement of client goals and expected

outcomes. These sequential steps provide a systematic format that ensures

continuity of client care and maintenance of professional standards while assisting

clients to regain, maintain, or promote health.

The nursing process is the unifying concept of nursing; it is the method by

which nursing is practiced systematically and provides the means by which nurses

demonstrate accountability and responsibility to clients and families.

Overview of nursing process

The purposes of the five-step nursing process are to establish a client data

base; identify the clients health care needs; determine priorities of care, goals and

expected outcomes; establish a nursing care plan and provide nursing interventions

to meet client needs; and determine the effectiveness of nursing care in achieving

client goals.

Relationship of steps of nursing process

Each step of the nursing process is essential to the problem solving technique

and is closely interrelated with the other four steps. During assessment, the nurse

collects data about the client from a variety of sources. This information is used for

problem identification so that planning and implementation are appropriate to the

client's needs; it is also the basis for accurate evaluation.

Nursing diagnosis involves formulating diagnostic statements that identify

the client's health-related problems. The accuracy of these statements depends on

54

the thoroughness of the assessment, including data collection, sorting and

clustering, and validation. The identified nursing diagnoses form the framework

for the nursing care plan. Nursing diagnoses thus provide the nurse with an

individualized client-centered focus.

During the planning step of the process, a care plan is formulated. It is

individualized based on the assessment and nursing diagnoses. The care plan

contains client goals with expected client outcomes and appropriate nursing

interventions. Expected outcomes are the criteria used to evaluate the effectiveness

of care.

Implementation is the action step of the nursing process. During this step,

individualized client care is delivered according to the care plan. Interventions are

continually modified as deemed necessary by an ongoing nursing assessment of

the client's responses.

The last step of the process is evaluation. The nurse determines the client's

progress toward meeting expected outcomes and achieving goals and the success

of the nursing interventions. This step provides for revision of the nursing care

plan as necessary to resolve the client's health problems.

The entire process is sequential and interrelated; each step depends on the

previous one. The sequence is logical in that client information is gathered before

determining the client's health care needs. Nursing care is provided according to

the plan, and nursing care is evaluated in terms of achievement of expected

outcomes. It is dynamic in that any step may be reviewed and revised during

evaluation. It is dynamic flexibility that allows the nurse to respond to changing

client needs.

Theoretical Comparison

The focus of nursing process is problem identification and resolution.

Problem solving and the scientific method are theoretical approaches used to

identify and resolve problems in nursing and other professions. The nursing

process shares several characteristics with the problem-solving and scientific

55

methods. The components of both can be correlated with each step of nursing

process.

Benefits

When the nursing process is used to organize and deliver nursing care, the

client becomes an active participant in an individualized health care process.

Through the planning phase, the care plan communicates to the health care team

the client's specific problems, the prescribed interventions, and the expected

outcomes of care. The client receives comprehensive and consistent care. The

evaluation of successful achievement of expected outcomes and quality

improvement studies document the quality of care promoted by the use of the

nursing process. The nursing process also assists in cost containment because

nursing care is based on client needs.

56

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