Mock tests are Harder than Test tests

Prior to the Introduction to Practice midterm, I drew up a mock test, without an answer key, to test my knowledge level.  I did well on the test.  Prior to the final exam for said module, I drew up another mock test, which begins at Erikson’s Theory of Development.

Feel free to take the entire test to gauge your own level of knowledge on the subject.













Give 3 examples of caring and uncaring behaviour



Give 3 indicators that a disease is chronic or acute



Explain Maslow’s Hierarchy of Needs, and why it is significant __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Explain the difference between signs and symptoms, give examples _____________________________________________________________________________________________________________________________________________________________________________________________________________

Contrast professional and friendship relationships


What are factors that contribute to health, and examples of practices that contribute to good and bad health?


What are the 12 Determinants of Health




What are the 6 Dimensions of Health


What are the 5 Dimensions of Holism



Erikson’s Theory of Development

Fill in the blanks & Matching

65+     E___ I______ vs D_______
6-12     G________ vs S________
20-40   I________ vs R___ C_______
12-19   C__________ vs I_________
40-65   I__________ vs I__________
3-6       I__________ vs G________
0-1      A__________ vs D________
1-3      T_____ v M______

5 Steps of the Nursing Process
4 Risk Factors for the Elderly
2 Most Common Locations for Falls
What is a Chart, and 4 Reasons They Are Used
3 Types of Aging
The Phases of Retirement:
R______ – _______________________________
N______ – _______________________________
H______ – _______________________________
D______ – _______________________________
R______ – _______________________________
S______ – _______________________________
T______ – _______________________________
3 Potential Legal Complications of Restraints:
Who orders restraints? _____________________
Identify Client Care Complications of Restraints:
Define Terms:
Geriatrics – ______________________________
Gerontology – ____________________________
Emotional Health – ________________________
Demographics – ___________________________
Chronological Age – _______________________
Historical Context – _______________________
Multiple Causation – _______________________
Culturally Competent – _____________________
Ethnicity – ______________________________
Cultural Health – _________________________
What are the psychological benefits of a client’s
Life Review? ____________________________

How’d you do?  I got 100% on the final, 68/68.

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Reflections on the Role of the HCA as a lifelong learner

To be a lifelong learner as an HCA, I need specific educational goals that relate to my field and practice as an HCA. My first goal is to complete my current education and practicum and become certified. From this initial step, I plan to get my Medication Administration Certification, whether through an employer or out of my own pocket. If I have
trouble getting the job I want as a fresh HCA graduate, personal expenditure shows commitment to my success in this field and will build my credibility with potential employers.

Whether before or after getting certified for Medication Administration, working in a hospital is the next step for me in my educational journey through health sciences. Working in a hospital is the most likely case to have my acute care course covered financially, therefore, as a lifelong learner, this is the most advantageous placement I can conceive. If I am unable to find a suitable employer or circumstance, this is another qualification I would pay out of pocket to further establish my credibility and commitment to advancing in this field.
Once, after several years, I feel I have maxed out my credentials as an HCA and developed my skills, I will have built enough clinical hours to be accepted to a bridging program or Access to Practical Nursing program. I understand that as an LPN, I will no longer be an HCA, but every member of the Health Care team is a support worker in a sense. As much as Support Worker is a specific occupational designation, every worker is there to support the client, from the DOC to the janitor. I feel I will be a more competent LPN having spent time as an HCA, and that I will be more confident in my duties and environment having worked in a related capacity.

As an LPN I will again have many career options. My initial interest in health care was Emergency Medicine and Medical Imaging. Paramedics is a field I am still likely to explore, although I may simply take an EMR course and do limited work in the field to add to my professional resume, also to satisfy my own sense of satisfaction and develop useful skills. That said, a likely course of action in the long term is I will study to become an RN BSc, and use that degree as an undergrad to study law, which is a fresh interest. As an individual in the Health Care field, one person can make a big difference, but you can’t help everyone. With further training, I believe it is possible for me to help a lot of people. This is absolutely in line with what I see as my greater purpose.

That said, I expect to be employed as an LPN within four years of graduating as an HCA.

An ideal HCA has an effect on a client’s prognosis. Palliative clients are cared for respectfully, and are allowed to pass from this mortal coil with dignity. Confused patients are grounded, demoralized patients may glean hope and patients who have lost respect for themselves through the disease process are approached with empathic equanimity which allows them to see themselves as still whole.

I have been told, that an HCA is one of the hardest roles to play on the health care team, but I disagree. The hardest role to play is that of a family member or loved one of a suffering client, or more difficult than that, to be a client yourself. Many of these diseases are demoralizing, may seem insurmountable, and may be. A client’s emotional outlook through this process very much affects the way the disease will present, and happier clients often
have a better outlook. If an HCA can treat this emotional ailment with warmth and compassion, then truly, that HCA is ideal.

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Highlights from the Journaling Project

My life has gone in a completely different direction than I would have guessed one year ago; a definite detour. While being an HCA would not have been my first choice initially, I’ve realized it’s the best choice, which opens up the most options. My entire life I’ve just wanted to make a positive difference. If I do this job well, it’s a guarantee.

 I was fortunate to have a sociology 101 teacher, an anthropologist, who told me to drop out of college, which was probably the best advice I ever got. A couple of years ago, a friend who I was working for, told me most people don’t make their money in their twenties, that it’s the thirties where you can really expect things to pay off. I took this to heart and haven’t looked back. After I quit working for him, I got a job cleaning highrise windows, which was my dream at the time. It didn’t pay well, so I went back to building …  months later, while commuting home from (site at) UBC, I was struck by a driver who forgot to look in his mirrors. I saw it coming. It was a crisis management situation where if I avoided him I’d be veering into oncoming traffic and if I had hammered the brakes, I’d have probably slid out in the rain and wound up under the vehicle. I feathered the brakes as much as was safe, slowed down and managed to ditch the bike as I landed. It was pretty terrifying.  (50cc of horror)

The reason I’m giving you this Reader’s Digest background, is to put my communication skills into perspective. I feel a bit like Slum Dog Millionaire coming into a situation like this, not necessarily looking the part initially, then doing as well as I am doing. My time in the theatre, the Optimist Club speech contest I didn’t place in when I was 10 years old, my time in the church, memorizing bible verses, and the self-reflection necessary to examine my faith in historical perspective to try and understand it and myself has culminated in my being the communicator I am. (and an atheist)  That, as I’ve been trying to explain to my cat, is life.

Common bonds, humour, camaraderie, commiseration and congratulations are the stuff of life to me. I see communication barriers as barriers to experience which are then only barriers to the self. When I look at my first five journals and see lists of successful communications, little jokes that I made to keep myself engaged, and finally a natural self-reflective entry at the correct point, I notice how in tune I am with my environment and it validates my concept of existence. To me this is a passive and constant form of communication.

This skill, keeping my faculties aligned, sensing myself, others and the environment, will be crucial in the situations where my training is tested. I am sure that with this course and positive mentoring in my practicum, I will be successful as an HCA, and in the health care field.

I did know that language was a barrier to my success with this curriculum, but I also missed what should have been an obvious trigger word. I’m speaking of the midterm, and not having picked up on the key word ‘non-verbally’ as I should have.

I understand that some of the questions are designed to display a competency in identifying which skill set the successful HCA will use in a given situation, however the application reminds me of a brain teaser. “Jane gets on the bus, wearing a blue dress. Billy boards the bus wearing a yellow shirt. Jessica and Jennifer are sisters and they get on the bus, Jennifer in blue and Jessica wearing green. Brian gets on the bus wearing purple shorts. How fast were they going?” That said, now I know what to expect.

The bus hyperbole would have served me well in the midterm, and I think is what drove my success on the final. Naturally I’m happy with my grade, but I have this nagging feeling that I could have done better, which is something I’ll have to address on my own. I will say for myself, I learned from my mistake.

My journals got pretty real after I wrote about my park beers drinking expedition, and I felt comfortable just expressing myself. I realize that I do listen empathetically, and that is why I have a lot of the amazing conversations I do with people I’ve just met. I spend a lot of time by myself sometimes, but I know that I bring value to the interactions I do have.

One element for improvement I picked out on January 21 is focus. A friend of mine has ‘focus’ tattooed in cursive just below his collar line. He’s a pretty smart guy. My focus was lacking. The interesting thing about that criticism, is I still remember the general flow of the conversation with J., the affective and verbal elements, despite being wholly absorbed by the material I was studying. We had had another conversation similar to that several days before, when I was skimming ahead in the textbook, with similar results. Somehow, (extremely focused rapid thought), I was able to competently listen to him, read, and at least partially absorb the text book, and do both simultaneously. I believe I shut out my extraneous thoughts, communicated with J. affectively with his 100 wpm, and spent my other 500 of the 600 wpm our brains can process, on wpm reading. I could only do it for about twenty or thirty minute blocks, and took breaks. Around four in the morning, he hit the couch and I stayed up reading for a couple more hours. Every time I stopped, I could feel my brain working to arrange everything I had just soaked up. Many new experiences are like that for me, soaking it all up like a sponge. It’s in my tool belt as an HCA: awareness. However, in therapeutic communication such behaviour while listening will not be inappropriate.

Certain books have helped shape my understanding of the mind: i-brain, which I highly recommend to every modern human; The brain that changes itself; and Journey to the centers of the mind. Understanding myself helps me better understand others. I believe I have the sensitivity and mettle to be a competent HCA. Burnout is always a concern. I try to take care of myself mentally and physically, but this position will not be easy. I believe a small helping of fear is healthy.

All in all, I feel I am an effective communicator, a skill which must be as actively pruned and maintained as a vineyard. I feel the different experiences I’ve faced have prepared me well to offer the vast majority of people I meet with a truly genuine empathy, although I have to actively manage my intrapersonal censors and filters to maintain open conversations with people from higher socioeconomic groups or with different cultural perspectives who may not understand my sense of humour or point of view on a particular subject. I have certain unpopular viewpoints that I can certainly back up, but refrain from addressing in polite society.

To be honest, this extroverted on-the-ball happy go lucky Tom that shows up in class every day is a side of myself I’ve been rather out of touch with, and I’m surprised at how easily it’s come back. I’d have to say this has been a very good two weeks, and I look forward to my continued success in this field.

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Keener Technique

Following the end of HCA 100, Interpersonal Communications, I distilled my notes from the module into an essay of the testable material.  The only thing that didn’t make it in here was open and closed questions; difference between and use of.  Either you know how to talk to people or you don’t is my take.  This study was not written for class, although I did get my teacher to look over it.  Call me a keener if you like, I got 100% on the test.

HCA 100


Final Exam, Study Essay

Professional communication is the key to becoming a successful Health Care Assistant. Through Active Listening and Therapeutic Communication techniques, which concentrate on enabling and enobling the client in their daily routines, an HCA can have a substantial effect on the working environment. Warmth is defined in Meriam-Webster’s Learner Dictionary as “2 : the quality or state of being kind or friendly ”. Empathetic Listening is a professional technique that conveys emotional warmth to the client and employs verbal and nonverbal communication skills in eliciting specific information, providing feedback and ascertaining that the individual needs of each client are met. Intrapersonal, territorial and extraneous factors distract from or distort the message, often by interfering with our listening process. Listening as compared to hearing involves taking in information, acknowledging the speaker in a way that invites communication and providing limited feedback to encourage continuing communication. Silence allows people to solve their own problems, validates them as individuals, and allows you to maintain a professional distance while offering a friendly ear or even a shoulder to cry on.

Listening involves three parts, taking in information, acknowledging the talker in a way that invites communication and measured responses. The listener provides limited feedback to continue a conversation or to get specific information to benefit care. As compared to hearing, listening requires a conscious interpretation of the holistic person; their physical emotional, spiritual and psychosocial needs.

The acronym DIPPS stands for Dignity, Independence, Preferences, Privacy and Safety. This is a good mantra to achieve a high standard of care. The client must be treated with the utmost respect at all times, including not patronizing them or their families, and being mindful not to use jargon which may confuse the average Jane or Joe.

Active listening is a technique, which makes use of silence, and requires cognitive energy to be applied while the speaker relates their thoughts. It is a non-judgmental communication technique that focuses not only on understanding the content but also on interpretation of the emotion of a message conveyed by the speaker. Active listening encourages rapport, builds trust, and allows you to build a more accurate profile of a client. 65-90 percent of communication in face to face interactions is conveyed nonverbally, making this an important skill to foster. Elements of professional communication include courtesy, assertiveness, the use of names and titles, responsibility and confidentiality. Professional individuals conduct themselves in a calm, confident, composed manner. It comes down to credibility. In discussion with a client, in full capacity as an HCA, you may need to say at some point, “If you’re planning to hurt yourself, I will have to tell someone.” At this time it becomes the HCA’s responsibility to report this conversation if they decide not to continue the conversation at that time.

Therapeutic communication is communication that benefits the client and should be used primarily in healing interactions. A attentive listener will face the client, use eye contact, lean in and employ active listening. Gender differences are recognized, as men often prefer side by side conversation, as compared to women, who also have different preferences regarding physical contact. Empathetic responses can include humor and hope where appropriate, focusing, clarifying, touch and even self-disclosure. The HCA must not give advice and should avoid confrontations, remembering always that perceptions vary widely based on experience.

Listening to yourself allows you to identify flaws and work on them. As you get to know your clients, “allow yourself to conform to the individual needs of your client.” Silence and encouraging para-linguistic responses as well as non-word utterances allows your client to solve their own problems, encouraging continuing independence as compared to a learned helplessness.

Non-judgmental participation is the key to active listening, and essential if one is to listen empathetically. To remain a neutral participant, concentrate on real observable traits and behaviours as compared to your perceptions of their conduct. Listening consists of hearing, which is the physical response; attending, engaging and focusing on the client; understanding, the decoding of the message in context of the speaker’s perceptions; responding, which is feedback; and remembering, which makes it all worthwhile. Empathetic listening is paying attention to the affection or feeling as well as the content of the message.

Listening consists of forty percent of the communication process. Sixty five to ninety percent of communication is non-verbal, and the majority of our time is spent broadcasting these signals; sometimes consciously, often not; these signals are usually trustworthy for this reason; this bolsters verbal communication. Your own non-verbal cues, as well as the ability to read the cues of others can evoke a huge emotional response including apologies and shame so it is important to be sensitive for this reason, especially of your own automatic responses.

Verbal communication is defined by the use of words to convey cognitive ideas, while nonverbal communication conveys affective information by the use of behavioural signals, symbols and para-linguistic kinesic factors like volume, rate, pitch, pausing and silence.

To the extent nonverbal communication can be used therapeutically, there is no limit. Certainly if a client has lost the will to live or is unresponsive, an HCA can offer the best care possible, and talk to their client despite an inability or unwillingness to engage. This conveys warmth empathy and respect. Loss of independence or a loss of control through life events or conditioning can lower self-esteem. Lowered self esteem often results in anxiety, stress, loneliness, depression and vulnerability to addiction. This can impair job performance and lead to under-achievement which in turn bolsters the negative internal feed back which often fuels the vicious cycle. A competent HCA advocates resident’s rights, quality of life, and should refer clients to counseling where appropriate.

Resident’s rights as defined by the Aphasia Society of Ontario include the right to be treated with dignity and respect, to participate in decision making regarding their own care, to know who will help you and to attend care conferences. Resident’s also have the right to information and the right to speak out. They have the right to be free from all facets of abuse and the right to privacy. In the words of the Aphasia Society, because as a resident, “This is your home.” As an HCA remember this at all times.

Elements of nonverbal communication include Kinesics, which are body movements; vocal factors, which include tone, pitch, volume, rate and silence; physical appearance; proxemics, which defines an 18” bubble as intimate, and a 36” zone as personal around any person; also haptics; phronemics and personal artifacts.

Kinesics, body movements, is closely related to Haptics, which is touch. Kinesics consists of gestures, body orientation, posture, facial factors which are the most visible but sometimes difficult to read. Posture changes are subtle but significant, and can signify a change in condition. These actions, while often unintentional effect communication for better or worse.

Another element of Kinesics is eye contact. In some cultures eye contact signifies aggression or disrespect, so remember to tailor communication to each client. In those with high self esteem, negative feedback will result in decreased eye contact while positive feed back elicits increased eye contact. In those with moderate self-esteem, any type of feedback at all will result in decreased eye contact and the person may be susceptible to ups and downs based on other’s perceptions. Those with low self esteem will avert their eyes when given positive feedback, but will often increase eye contact with negative feedback. It is important not to examine just one non-vocal factor, but assess the whole person when responding empathetically.

Touch, or haptics is extremely powerful, especially to those who have been deprived. It offers warmth, comfort, support, reassurance, congratulation, acceptance and interest. Genuinity is when a person’s inner thoughts match their outer actions, and this quality is readily apparent in those who posses it. Use the LEARN model of conflict resolution if you are uncomfortable with a level of contact with a client, providing it will not adversely affect their care.

An HCA providing Perineal Care, which is the cleansing of the perineum and surrounding region, must be especially careful to maintain professionality. This is when a client is at their most vulnerable, and small signals can be easily misinterpreted. The successful HCA will recognize gender differences. Women are often more discriminating about where they are touched while men are often more concerned about how. As an HCA responsible for perineal care, it is a personal responsibility to ensure that a client is comfortable receiving care from them in that way. It is important to respect a client’s body as they would respect it themselves, to never “undress a client and just leave them there.”

Never underestimate your client and remember, that touch forms a connection. This can be especially important for those who are disassociated or confused and can be grounding.

When caring for a client’s personal items or artifacts, especially a prosthetic, exercise absolute care. For some clients, an item may hold immense sentimental significance, or may be important to them spiritually. Active listening will enable you to build common bonds with your clients to better empathize with them.

The intimate field is defined as 18” from a person’s body, and their personal space is defined at 3 feet. While haptic touch can be therapeutic, it is important to respect a person’s physical and psychological space. Active listening ensures you are able to provide respectful care.

There are many factors why people fail to listen. These include stimulus overload, preoccupation, distractions, rapid thought, incorrect assumptions, talking may seem more advantageous, or we may never haver learned to listen properly. Stimulus overload can be managed if attention is paid to the environment and there is an active effort to focus. Preoccupations can be managed with mindfulness and non-judgmental self-awareness, stilling the inner environment. Distractions can be minimized and rapid thought can be stilled or focused, as to be fully engaged. Incorrect assumptions are actively abandoned as they arise and the listener must focus their attention on the source, allowing the person to address their own dilemma. This technique promotes effective listening and should be employed wherever appropriate. You have to care for yourself to effectively care for others, and it is important to “Start your day over at any time” with a clean conscious and a clear mind. By constantly refreshing themself, the HCA can avoid the pitfalls of burnout.

To manage personal non-vocal cues, the care professional may employ the SOLER technique. To do this, Square your ShoulderS, Open yOur pOsture, Lean forward, Engage EyE contact, Relax youR postuRe. This shows the client you are genuinely interested and allows you to fully engage.

Empathetic listening requires empathic response. Vocal stroking reassures and validates; it lets the speaker know that if you need to ask a question you will. It is important to allow for full thoughts, but don’t wait until the moment has passed to ask important questions. That said, respond sparingly, for the speaker may answer the query you are about to ask. Take notes if necessary and show a willingness to listen. Restate the essential content and feeling. Clarify using open and closed questions as appropriate. Verify the information through measured feedback, remembering to focus on real observable or conveyed information as compared to your own perceptions of it, to allow as much as possible for a client’s individuality and autonomy.

In the unfortunate situation that a client is offended, humbly apologize and seek to make reasonable restitution or to avoid such personal missteps in the future. Always respect the disease process, and try to make life as comfortable for your clients as possible. Joy and comfort relate closely to the will to live, which is integral to anyone’s survival whether sick or well.

Knowing when to be silent is more important than knowing what to say. Understanding that 65-90% of face to face communication is conveyed nonverbally puts therapeutic communication and active listening into their proper clinical perspective. These important skills which create an empathetic listening environment and convey warmth are integral to a client’s well being. Personal body language, as well as use of healing haptics encourages rapport. Personal management of the primary reasons one may hear and not listen bolster this trust environment. Empathetic responses maintain a professional but ‘real’ space for a client to explore their own emotions throughout their treatment. The HCA is a sounding board, not giving advice but often paraphrasing the client, to fulfill their love and belonging, self-esteem, and physiological needs. Silence and real presence can mean the world to someone, and real communication depends more on what is unsaid, than what is.

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As part of the program, our learning skills were assessed and we were to set goals in applicable areas.  I scored very high in everything except, ba ba baaaa!  Time Management!

No surprise.  Goal #1 has yet to happen, but #2 and #3 are well underway.



Thomas Liddle

January 10, 2012

HCA PRO100: LASSI Assessment and Learning Skills Goals


Learning Goals & Strategies Assessment


Learning Goal 1: To Improve My Concentration


Strategies: Keep a tidy workspace. Use the small monitor for my studies and leave the big screen off. Listen to calming background music rather than raucous rabble-rousing tunes except where appropriate.


Learning Goal 2: To Improve My Time Management


Strategies: Study every day. Minimize social contact so as to be fully immersed. Look ahead and plan for subjects that are going to require more intensive studying.


Learning Goal 3: To Not Procrastinate


Strategies: Work ahead as much as possible. Attempt to stay one step ahead in readings, skimming, as a preview for the content to follow. Develop flash cards along the way so quiz and test studying is incorporated and natural. Take notes furiously and plan citations and quotations far in advance of having to make any.

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Trick Question

It’s not feedback, it’s your first entry:

I’m Tom Liddle, an HCA student at Stenberg College in Surrey British Columbia, Canada, (Cohort 0112). Entering the Anatomy and Physiology module, I have an overall average of 99%, not too shabby.  In this blog, I will record my progress and techniques.

I have been using this game to hone my skills in anatomy.

There is at least one minor mistake in the game.  Can you find it?  Free for android:

Speed Anatomy


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