Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 1 of 10 Activity 3: TRANSFER TO A WHEELCHAIR Future tense Learning Goal(s) Demonstrate the indirect and direct skills necessary for correct transfer of a patient with one-side weakness to a wheelchair. Materials (handouts provided below) Realia (teaching aids): wheelchair, transfer belt, student as resident in bed in mock patient unit Sentence strips, envelopes and tape Handout A: One Person Gait Belt Transfer Handout B: 1-Person Transfer To Wheelchair - What To Say Handout C: Future With Going To Grammar Guide Handout D: Written Exercises Handout E: Future With Will Handout F: Written Quiz Procedure 1. The content instructor demonstrates the skill and why each step is important. 2. Students read the directions for transfer to a wheelchair (Handout A: One Person Gait Belt Transfer). 3. ESL instructor reviews and checks for understanding a. Discuss any words that are hard to pronounce or understand. b. Asks students the importance of each step. 4. Students and ESL instructor read the Handout B: 1-Person Transfer To Wheelchair - What To Say a. ESL Instructor calls attention to fact that the CNA explanation to resident requires the use of future. b. Students identify sentences that use the future. c. Students practice reading and saying the sentences from the communication guide 5. ESL instructor provides grammar review using the Handout C: Future With Going To Grammar Guide. 6. Students work in groups of three around each bedside taking one of the three roles below. Student A: CNA Student B: Resident Student C: Reader a. Student C reads each step one at a time and uses the future to tell Student A what he is going to do. b. Student A performs the skill while giving explanations and other needed communication, especially using the future tense. c. Students trade roles so each has a change to practice. 7. Students complete written grammar exercises in Handout D: Written Exercises. 8. Students make own future questions about the skill then take turns asking and answering classmate s questions. 9. Practice walking dictation with steps listed in Handout A: One Person Gait Belt Transfer: a. Take several of the sequential steps in simplified form and make sentence strips. b. Tape the sentences on different walls of the room in no particular order.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 2 of 10 c. Pair students up. Students A s go up to a strip, read it, go back to student B and dictate. (No shouting across room, make more than one trip if necessary) d. Continue until all sentences are dictated and change roles. e. Make corrections, put sentences in the correct order, adding sequencing words 10. Using Handout E: Future With Will create sentence scrambles. Enlarge and cut up the words from some question and answer sentences in future. Place each set in envelopes. Scramble the words and have students recreate the questions and answers, documenting their answers on the handout. 11. Students complete Handout F: Quiz. Review quiz answers and discuss questions. Assessment: Instructor can conduct an informal assessment of oral skills as students perform exercises and utilize quiz results to evaluate progress or for a grade if desired.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 3 of 10 Handout A: One Person Gait Belt Transfer Adapted from CNM PRINCIPLES OF NURSING ASSISTANT LAB 1093 1. Knock on door, greet patient, identify yourself and confirm the resident s identity by asking name and checking ID band. 2. Explain what you are going to do and ask if it is a good time or if the resident needs anything first. 3. Ask which side is the strong side. Remember, the strong side will move first and bears the resident s weight 4. Gather your equipment: Wheelchair, gait belt, the person s footwear (non- skid shoes) 5. Visualize how you will do the transfer, what side of the bed should the person be on and where to position the wheelchair. 6. Remove both footrests and the arm rest on the side in the way of the transfer. (Arm rests can stay on the bed or nearby furniture. Leg rests should stay on floor out of the way.) 7. Remove all other obstacles in the way. 8. Before starting the transfer make sure their foot wear is in reach but out of the pathway of the transfer. 9. Put with the head of the bed (HOB) flat. 10. Raise the level of the bed to a working height. Make sure the side rail is up. 11. Look at the distance of the body from the edge of bed. If the person s elbow (bend the arm) is near the edge of the bed, a safe distance is usually assumed. 12. To make sure you are not turning the person on top of their arm, raise the arm up on the side you will plan to turn the person on. 13. Cross the person s furthest leg over the ankle in the direction you are going to turn the person. 14. Assist the person to roll onto their side facing you. Ask the person to help by reaching for the side rail 15. Stack the person s legs, pull their knees up toward their chest with their heels resting just on the edge of the bed 16. The bed level should be lowered at this time. Start to raise the HOB as you watch the feet go off the side. You may need to stop to assist the legs in dropping off the side. 17. Raise the HOB until the person is in an upright position. 18. Communicate with resident to use strong side to push up from the mattress or side rail. 19. Ask the person if he or she feels OK or is experiencing any dizziness. Allow time to dangle. 20. If resident is stable, put non-skid shoes on feet. 21. Properly place the gait belt around the resident s waist.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 4 of 10 22. Make sure that resident s feet are flat on the floor (scoot resident forward to the edge of the bed if necessary) 23. Make sure that resident s feet are under their knees. 24. Position the wheelchair closely on the strong side of the person. 25. Lock the brakes on the wheel chair. 26. Position the inside of your knees on the outside of the residents knees; your feet right beside their feet. Aim your toes slightly in the direction of the move. Bend your knees slightly. 27. Explain the transfer move to your person; As you begin the transfer you will hold on to them with the gait belt and expect them to assist you by standing on their strong leg (Touch their good leg), pivoting to the chair, and reaching for the wheel chair arm rest. 28. Bend at your hips, stick out your bottom to maintain lumbar curve. 29. Reach under the person s arms and hold on to the gait belt as close to the back s center as possible. Instruct the person to lean into you. 30. Before moving, let the person know that the two of you will rock back and forth and move on the count of 3. Remind them what you expect them to do. 31. On the count of three transfer the person maintaining good body mechanics (no twisting, pivot your feet and move entire body as one piece) 32. Position the person in their wheel chair. Make sure their bottom is far back in the chair, that they are well supported and in good alignment. 33. Remove the gait belt 34. Replace the foot and arm rests of the wheel chair. 35. Open curtain 36. Check for safety and comfort 37. Wash your hands. 38. Record and report Notes: When parking the resident in a wheel chair, pull the chair backwards slightly so that the small directional wheels in the front will be moved to the forward position. This will make it more difficult for the wheel chair to tip forward if a person tries to stand without assistance. Record the skill and (not limited to) the person s self- performance, what support and safety measures were taken and how well they tolerated the procedure.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 5 of 10 Handout B: 1-Person Transfer To Wheelchair - What To Say May I come in? Hi. My name is. Knock on door I m a CNM Nursing Assistant Student. I ve washed my hands. Can you tell me your name and birthdate? The nurse asked me to get you in the wheelchair to go to lunch. Check wrist band. Is now a good time? Which is your strong side? I m going to put your bed up. Do you have your clothes on? Check bed brake. Get wheel chair set up. Put gait belt nearby Close the curtain! Bed to working level. Patient flat. Check before lowering linen. Staying flat, resident moves a little from center. Can you scoot over a little? OK. I m going to get ready to turn you on your side. Arm up at side with arm bent 90 degrees. Other arm over chest Tap hand that is over chest. When I turn you, you can hold the side rail with this hand. Ok. I m going to roll you on your side now. Put hand on shoulder blade and hip. Roll resident on side. Bend your knees to your chest. I m going to slowly raise you to a sitting position. Slowly raise head while taking
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 6 of 10 feet off bed. How do you feel? Are you dizzy? I m going to put on your shoes. Let resident dangle while you put on shoes. I m going to put on this belt for your safety and mine. Let s get you closer to the side. Put your arms on my elbows as I lean you over and move your bottom. I m going to count to 3 and rock you. When I say 3, put your weight on your strong leg and turn to the chair. Resident s feet flat on floor. Position wheelchair. Lock brakes! Show how you will rock her. Pat the strong leg. Are you ready? 1.2..3 Pivot patient into the chair Let s get you back a little. 1 2 3 Let s get you comfortable. Are you ready? Here we go. Use gait belt to move resident back. Put on WC arm and foot rests. Take off gait belt. Open curtain
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 7 of 10 Handout C: Future With Going To Grammar Guide Subject + am, is, are + going to + verb (simple form) I am (I m) going to help you get dressed You are (You re) going to need another pillow. He is (He s) going to eat later. She is (She s) going to wash the other patient first The nurse is going to give you an injection. We are (We re) going to make the bed They are (They re) going to come back later Negative I am not I m not going to You are not You re not going to He is not He s not going to We are not We re not going to Using Question Words give the medicine need extra help Question word + verb be simple present + going to We aren t going to You aren t going to He isn t going to The nurses aren t going to She s not going to She isn t going to The doctor s not going to They re not going to They aren t going to Where am I going to take this resident? When are you going to feed him? Why is the doctor coming to see her? How is he (she) going to change the colostomy bag? What time are we going to get the residents ready for lunch? Who are the Johnson s going to eat with? (object - informal) With whom are the Johnson s going to play cards? (object - formal) Who Subject Who is going to take her vital signs?
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 8 of 10 Handout D: Written Exercises Instructions: Use be+ going to + verb to form these future statements. Use contractions if possible. 1. The doctor/see you/this afternoon. 2. The nurse/give you your medicine in 1 hour. 3. X-ray tech/take an x-ray of your arm 4. We/roll you on your left side 5. The OT/show you an easy way to button your shirt. 6. I/take your blood pressure 7. The custodian/mop the floor 8. I/transfer you to the wheel chair. Now change your sentences to negative. 1. 2. 3. 4. 5. 6. 7. 8. Make future where, when, what, why, how questions that match with the answers. Example: How is the CNA going to speak to a resident who is hard of hearing? The CNA is going to speak clearly and slowly to the resident who is hard of hearing. 1. Mr. Henry is going to eat in the cafeteria. 2. Mrs. Nguyen is going to be discharged at 3PM. 3. The accident victims are going to arrive by ambulance. 4. I m going to answer his call light next. 5. I m going to ask if he needs to use the bedpan first because I want him to be comfortable.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 9 of 10 Handout E: Future With Will Will + verb in simple form I will (I ll) need to bring some money. You will (you ll) He will (He ll) She will (she ll) Mark will It will (it ll) close at 6pm. We will (we ll) They will (They ll) Will not or won t + simple verb Negative use won t (will not) I won t turn off the light You He She We They The nurses will Yes/No Questions Will (I, you, he, she, it, we, they, the staff, the CNA s get paid next week?) Yes (I, you, he, she, it, we, they) will. No ( I, you, he, she, it, we, they) won t Question Words When will I get paid? Why will he need the medicine? Where will the conference take place? Use the future with will to form these future statements. 1. The doctor (talk to you tomorrow) 2. He/need your permission for the surgery. 3. The family (have to wait for 20 minutes) 4. I (see you next week) 5. The nurse (change your dressings) today 6. You (have a clear liquid diet after surgery) 7. I (give you your bath in 5 minutes) 8. You (need) a walker at home. 9. Your children (visit) tonight. When you are finished you can turn the sentences to negative using won t. Make your own questions in future and ask your fellow students to answer.
Contextualized Grammar I-BEST SUN Path Curriculum Unit for Nursing Assistant with ESL Support - Page 10 of 10 Handout F: Quiz Instructions: Find the errors in these future tense sentences and rewrite the sentences correctly. 1. Is she going explain to the resident what will happen? 2. The nurse and physical therapist is going to help. 3. I assist you in a moment. 4. He no stay in bed for very long. 5. Where you going to be in if I need you? 6. She see him tomorrow. 7. The pharmacy are going to open at 9. 8. When you will call the doctor? 9. I going to get you up in the wheelchair. 10. They no have time on Tuesday. Re-write the steps for transfer to a wheelchair in the correct order and add several different transition words. A. Move the resident to the back of the wheelchair. B. Let resident dangle at side C. Wash your hands. D. The resident puts weight on strong leg and pivots to chair. E. Wash your hands. F. Record and report. G. Introduce yourself and check ID of resident. H. Raise the bed to working level. I. Raise HOB as legs come off bed J. Rock the resident and count to three, K. Adjust the wheelchair position and put on brakes