1. WELCOME ABOARD AND GOOD BYE Admissions and Discharges

2. Welcome aboard Be understanding of new resident’s losses and life-altering changes Prepare the room so it would like a home “ The best thing we can do is to make wherever we are in look as much like home as we can” Christopher Fly, 1907-2005 Personalize their space with flowers and a greeting postcard

3. My new very little space now… But it is my space…

4. Welcome aboard Greet them with respect Introduce yourself and ask them how they want to be called Introduce them to their room, bathroom, and roommate first, help with items to be arranged, then introduce them to the facility, activities, meals time, and menu While doing the tour, introduce them to people in the hall either they are residents or staff members, but be careful, don’t overwhelm them with too much information

5. Let me know you

6. Family Talk to family. Ask them about resident’s habits, traditions, and preferences in meals and sleeping time.

7. Valuables and personal belongings Valuables as money, wallets, jewelry, passport, and important documents should go to the facility safe Have second person to count money with you to be a witness Make a list of all personal belongings on admission, including valuables, make family to sign the paper Place personal items per resident’s preference Make their environment welcoming and home-like Adjust temperature in the room per resident’s preference, not yours

8. Admission pack May include different items per facility protocol Normally it is water pitcher, toothbrush and toothpaste, comb, Kleenex, big and kidney basin, and bed pen or urinal if needed Activity – collect the admission pack for the resident in groups

9. Let sunshine to come to the room Per nursing home requirements, unless resident requires otherwise, shades should be open during the day and closed at night If not, resident’s get confused on a day time and change their sleep pattern

10. Assisting with the physical exam

11. Check resident's baseline vital signs Activity – check vital signs on each other – T, HR, RR, BP, O2SAT, pain level. Also check their weight, and height Baseline vital signs are the initial ones taken at the time of admission.

12. Conversion of weight to metric system Activity – convert weight of your patient into kilograms To convert kg to pounds: multiply by 2.2 To convert pounds to kg: divide by 2.2

13. Convert to pounds Convert to kilograms 1. 70 kg 2. 3.5 kg 3. 0.4 kg 4. 12 kg 5. 200 kg 6. 40 kg 7. 50 kg 8. 80 kg 1. 150 lb 2. 5 lb 3. 8 lb 4. 26 lb 5. 600 lb 6. 300 lb 7. 24 lb 8. 141 lb Medical math

14. Height of a patient in a bed is measured by measuring tape p. 144 Activity – measure the height of the mannequins in groups. Skill on p. 144 Activity – measure the abdominal girth of your mannequin, logroll them for placing and taking tape off, never pull the tape from under the patient to prevent skin tear

15. Assisting with the physical exam

16. Know what you need to gather, have a little notebook for the specific exam’s equipment Know positions which are required for the particular exam and position patient accordingly

19. Dorsal recumbent Is used for the chest, abdomen, and perineal area exams

20. Lithotomy position Is used for the exam of the vagina and pushing period in labor

21. Knee-chest position Rectal exam

22. If you are present in the exam room Be ready to comfort the patient, since sometimes patients are anxious about what examiner will do during exam and fear of the pain and the results of the exam

23. Discharge Discharge is only official after the doctor writes the discharge order NAC helps the resident to pack to be sure that all items are packed Leaving the facility without doctor’s order is called AMA – against medical advice. If you see patient leaving the facility, or going to, notify the charge nurse immediately, and ask patient to sign the AMA paper to save facility from liability. When discharge patient, your responsibility does not end until the doors of the vehicle closed.

24. Find good words for your patient on discharge Good bye! Activity – find the words for the patient on discharge, when you help them into the car and wave good bye. Write them in the orange sheet.