1. Textbook For Nursing Assistants
Chapter 6 – Those We Care For
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

2. Those We Care For
There is much more to being a nursing assistant than blood pressures and bedpans
A health care worker can go to the most well-known schools, receive the most intense training, and graduate at the top of his class, but if he is not able to connect on a human level with his patients or residents, he will fail
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

3. Patients, Residents, and Clients
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

4. Patients, Residents and Clients
A Patient
A Resident
A Client
A person who is receiving health care in a hospital, clinic, or extended-care facility
A person who is living in a long-term care facility or an assisted-living facility
A person who is receiving care in his or her own home, from a home health care agency
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

5. Those We Care For
There are three general types of illnesses or conditions that can cause a person to need health care services:
An acute illness
A chronic illness
A terminal illness
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

6. Acute Illness
An acute illness is a condition characterized by a rapid onset and a relatively short recovery time
Because the onset is rapid, acute illnesses are usually unexpected
Examples:
Pneumonia
Appendicitis
A broken bone
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

7. Chronic Illness A chronic illness is a condition that is ongoing
Examples:
Diabetes
Asthma
Arthritis
High blood pressure (hypertension)
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

8. Terminal Illness
A terminal illness is an illness or condition from which recovery is not expected
Examples:
Some types of cancer
End-stage emphysema
Some heart conditions
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

9. Those We Care For: Grouping
PEOPLE
Grouped according to ages
Grouped according to type of illness and medical condition
Grouped according to special needs
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

10. Those We Care For: Grouping
Terms that are often used to describe people:
Surgical patients
Medical patients
Obstetrical patients
Pediatric patients
Geriatric patients
Psychiatric patients
Rehabilitation patients
Sub-acute or extended-care patients
Intensive care patients
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

11. Surgical Patients
Have illnesses or conditions that are treated by surgery
Examples:
Appendicitis
Certain types of tumors
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

12. Medical Patients
Have an illness or condition that is treated with interventions other than surgery, such as medication, physical therapy, or radiation
Examples:
Pneumonia
Myocardial infarction (“heart attack”)
Stroke
Some stomach disorders (such as ulcers)
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

13. Obstetrical Patients Are pregnant or have just given birth
Obstetric care extends throughout the pregnancy and labor and delivery, and then continues for about 8 weeks after delivery
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

14. Pediatric Patients Are children and adolescents
Sometimes special considerations must be taken into account when providing treatment and care for younger patients, because a child’s body does not function in exactly the same way as an adult’s
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

15. Geriatric Patients Are older adults (i.e., those 75 years and older)
Health care workers who specialize in geriatrics are trained to recognize the physical and mental effects of the normal aging process and help older adults adjust to these changes
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

16. Psychiatric Patients Are people with impaired mental health
Are often treated on an outpatient basis, using a combination of counseling and medication
If deemed a danger to themselves or others, may be admitted to a health care facility for treatment
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

17. Rehabilitation Patients
Are those who are undergoing therapy to restore their highest level of physical, emotional or mental, or vocational functioning
Examples:
People born with physical disabilities or deformities
People who have had a stroke or are recovering from surgery or an injury
People with substance abuse problems
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

18. Sub-acute Patients
Are usually recovering from an acute illness or condition
They do not need the total care provided by a hospital, but are not quite ready to return home
Examples:
Intravenously administered medications
Physical therapy
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

19. Intensive Care Patients
Patients needing very specialized, or intensive, care are usually admitted to an intensive care unit or a special care unit
Examples:
After heart or brain surgery
After suffering from a heart attack or stroke
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

20. Growth and Development
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

21. Growth and Development
Changes that occur physically are known as growth
Growth is demonstrated by changes in height and weight and by physical maturation of the body’s organ systems
Changes that occur psychologically or socially are known as development
Development is evidenced by changes in a person’s behavior and way of thinking
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

22. Principles of Growth and Development
Occurs continuously throughout a person’s lifespan, from conception until death
Occurs step by step and in an orderly progression. Each stage has specific characteristics and tasks that must be accomplished before the person can progress to the next stage
Tasks of growth and development progress from the simple to the complex, head to toe, and from the center of the body outward
Occurs at variable rates for each individual, and may occur unevenly or in spurts
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

23. Stages of Growth and Development
Infancy (birth to 1 year)
Toddler hood (1 to 3 years)
Preschool (3 to 5 years)
School-age (5 to 12 years)
Adolescence (12 to 20 years)
Young adulthood (20 to 40 years)
Middle adulthood (40 to 65 years)
Later adulthood (65 to 75 years)
Older adulthood (75 years and beyond)
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

24. Stages of Growth and Development
Infancy (birth to 1 year)
Physical and psychological changes occur most rapidly
New tasks are accomplished on a weekly and monthly basis
The infant begins to smile and laugh, recognize parents and siblings, play peek-a-boo, and say simple words
He progresses from drinking only mother’s milk or formula to feeding himself solid foods
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

25. Stages of Growth and Development
Toddler hood (1 to 3 years)
Physical growth slows down during toddler hood
Development of the muscular and nervous systems allows the toddler to become quite active and permits greater control of the bladder and bowels
Toilet training begins
The toddler learns the words to express emotions, such as “sad” or “scared”
Remember that medical procedures that require separation of the child and the caregiver can be very frightening for a toddler
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

26. Stages of Growth and Development
Preschool (3 to 5 years)
The preschooler’s physical coordination improves a great deal, and she learns to dress herself and tie her own shoes
Toileting becomes more independent
Children become aware of gender differences
Begins to develop a conscience and is able to more easily follow rules
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

27. Stages of Growth and Development
School-age (5 to 12 years)
Major physical growth spurts lead to increase in both height and weight
Improvement in writing and drawing ability
Actively seeks approval from authority figures and peers
Morals develop and school-aged children may feel very strongly about issues being either right or wrong, with no gray area
Spirituality and religious beliefs, as well as a concern for other living things, also take root during this developmental stage
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

28. Stages of Growth and Development
Adolescence (12 to 20 years)
Adolescence begins at the onset of puberty
Physical growth and development during adolescence is considerable
Psychologically, the period of adolescence is stormy
Adolescents may be self-conscious about their changing bodies and increased awareness of their own sexuality
They begin to question the moral teachings of authority figures and parents
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

29. Stages of Growth and Development
Young adulthood (20 to 40 years)
Young adults typically enjoy stable, supporting friendships and good health
The physical changes that occur in young adults are generally minor
The adult height is achieved during adolescence
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

30. Stages of Growth and Development
Middle adulthood (40 to 65 years)
Middle adulthood frequently finds people at the height of their careers and productivity
Adults find themselves in the role of caretaker to their children as well as to their aging parents
Physically, the middle adult begins to show signs of aging, such as wrinkles or a few gray hairs
Women typically experience menopause
While good health is usually still enjoyed, some chronic illnesses, such as hypertension and diabetes, become apparent during this stage
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

31. Stages of Growth and Development
Later adulthood (65 to 75 years)
The physical signs of aging and the development of chronic illnesses become more prevalent
Strength diminishes, as do many senses, such as hearing and sight
During this stage, many people must cope with the loss of friends or a spouse due to death
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

32. Stages of Growth and Development
Older adulthood (75 years and beyond)
A primary task in this stage is preparing for one’s own death
Many must adjust to failing health and a growing dependency on others
Enjoy sharing the wisdom of their years with younger people
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

33. Basic Human Needs
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

34. Basic Human Needs Clearly, all patients and residents are not alike
The people you will care for will be in different growth and development stages, and as such, they will have different needs
The primary mission of health care is to administer to the physical and emotional needs of those we care for
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

35. What Exactly are Needs? Maslow’s hierarchy of human needs
A need can be defined as something that is essential for a person’s physical and mental health
Abraham Maslow (1908–1970), a famous American psychologist, defined what he thought to be the basic human needs
Maslow’s pyramid, called Maslow’s hierarchy of human needs, reflects Maslow’s belief that the more basic, lower-level needs must be met, at least to some degree, before the higher-level needs can be met
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

36. Maslow’s Pyramid Needs to be met first
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

37. Physiologic Needs
Oxygen, water, food, shelter, elimination, rest and sleep, physical activity, and sexuality
Meeting the physiologic needs is essential for survival and is of the highest priority
A person must have enough oxygen or he will die within minutes
Nursing assistants perform many duties that assist patients in meeting their physiologic needs:
Assisting with meals
Toileting
Ambulating
Providing a relaxing environment in which to sleep
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

38. Safety and Security Needs
Safety and security needs are both physical and emotional
Nursing assistants follow policies and procedures that are designed to ensure their own safety, as well as that of their patients or residents
To prevent the spread of infection, a nursing assistant follows the procedure for handwashing
In order to protect a resident who is at risk for falling, the nursing assistant always makes sure that the resident has his walker close at hand
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

39. Love and Belonging Needs
All people need to feel loved, accepted, and appreciated by others
People meet this need for one another by showing affection and forming close (intimate) relationships
By taking an interest in the person and showing respect for the person’s specific likes and dislikes, nursing assistants can help to meet that person’s need to feel loved, accepted, and appreciated by others
A smile
A kind word
A gentle touch
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

40. Self-esteem Needs
Self-esteem is influenced by how a person perceives herself, and how she thinks others perceive her
Everyone wants to be respected and thought well of by others
Many things can affect the self-esteem of a person who is receiving health care, such as:
Having to wear a hospital gown
Having surgery that might cause the person’s physical appearance to change
Having to depend on others for something he used to be able to do for himself
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

41. Self-esteem Needs
Nursing assistants help to preserve their patients’ and residents’ self-esteem by:
Providing for privacy when it is necessary to expose someone’s body
Allowing people to wear their own clothing
Assisting people with basic grooming
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

42. Self-actualization Needs
The highest level on the hierarchy of needs is self-actualization
In order to achieve self-actualization, a person must reach his or her fullest potential
Examples of goals that patients or residents may have include
taking one step (for a person who has had a stroke)
delivering a healthy baby (for a pregnant woman)
returning home (for a person who has broken a hip)
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

43. Basic Human Needs
By helping people to meet their most essential needs first, you will enable them to meet their higher-level needs. For example
It is difficult to work on a person’s self-esteem if he is struggling to breathe!
Recognizing needs that people have difficulty meeting on their own, and helping them to meet these needs, is one of the most valuable contributions you will make as a nursing assistant
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

44. Human Sexuality and Intimacy
All human beings are sexual beings
Heterosexuals are attracted to members of the opposite sex
Homosexuals are attracted to members of the same sex
Bisexuals are attracted to members of both sexes
Transsexuals believe that they should be members of the opposite sex
A transvestite is a person who becomes sexually excited by dressing as a member of the opposite sex
In fact, most transvestites are heterosexual men
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

45. Nursing Assistants and Sexuality
There are many ways that, as a nursing assistant, you can help patients and residents to fulfill their need to be thought of as sexual beings
Avoid being judgmental
Help your patients and residents with rituals that make them feel either feminine or masculine
Allow for privacy
Always knock before entering a person’s room
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

46. Culture and Religion
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

47. Culture and Religion
Culture is another thing that makes human beings human. Culture is made up of the beliefs (including religious or spiritual beliefs), values, and traditions that are customary to a group of people
While racial identity is often mixed with a person’s culture, race is a general characterization that describes skin color, body stature, facial features, and hair texture
A person’s spiritual beliefs, or religion, are often very closely linked with his or her culture
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

48. Culture and Religion
Throughout your career, you may be lucky enough to care for people from many different cultural and religious backgrounds
You will most likely encounter situations, practices, and beliefs that no book could have prepared you for!
Take time to listen to your patients or residents, and to learn from them
Exposure to cultures other than your own is enriching, both professionally and personally
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

49. Respecting The Individual
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

50. Respecting The Individual
As a health care professional, you are trained to care for a person’s physical needs
A holistic approach to health care takes into consideration a person’s emotional needs as well as his or her physical ones
Making an effort to accommodate a person’s cultural beliefs and practices and allowing patients and residents to make decisions related to their own quality of life is one way that health care workers provide holistic care
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

51. What is it like to be a Patient or Resident?
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

52. Being a Patient or a Resident
What is it like to be a patient?
Patients feel scared and lonely
They feel sick
They are unsure about their health, now and in the future
What is it like to be a resident?
Must adjust to loss of independence
Must adjust to new home, and possibly a roommate
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

53. …a person who needs you very much
The Nursing Assistant and the Individual
When you must care for a patient or resident who makes you wish you had never chosen to be a nursing assistant (and you can be certain you will encounter patients or residents like this), stop and think for a moment about the reasons that person may be acting out of sorts
When you look beyond the illness or condition, past the technical duties and procedures, and into that person’s eyes, you will find your reason for choosing to be a nursing assistant
…a person who needs you very much
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

54. End of Presentation
Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.