LG27315v1 27317v1 28530v1 28531v1 28532v1 28533v1 28534v1 28549v1 PDF

Learning Guide
Working as
an orderly
27315 Describe and implement strategies for de-escalating Level 4 3 credits
unwanted behaviour in an aged care, health or disability context.
27317 Prepare a deceased person for viewing when working as an Level 3 3 credits
orderly in a health or disability context.
28530 Move and store equipment in a healthcare facility. Level 3 7 credits
28531 Transport people in a healthcare facility. Level 3 5 credits
28532 Transport a deceased person in a healthcare facility. Level 3 5 credits
28533 Transport body parts in a healthcare facility. Level 3 5 credits
28534 Support the effective functioning of a healthcare facility as Level 3 5 credits

an orderly.
28549 Collect and transport healthcare waste in a healthcare Level 3 3 credits

facility.
Name:
Workplace:
Issue 1.0
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All rights reserved. Careerforce (Community Support Services ITO Ltd) is the owner of the copyright
of this publication. Other than as permitted by the Copyright Act 1994, no part of this publication
may be reproduced, copied or transmitted in any other form or by any means, without prior
written permission of Careerforce, PO Box 25 255, Christchurch, 8144, New Zealand.
Contents
Introduction ............................................................................................................................. 1
Your role as an orderly ............................................................................................................ 3
A day in the life of an orderly .............................................................................................. 3
Working as part of a team ................................................................................................... 4
Supporting your team .......................................................................................................... 5
Looking after people ................................................................................................................ 7
Transferring people ........................................................................................................... 10
Patient care items and personal effects ............................................................................ 11
Transporting people’s medical records ............................................................................. 12
Moving someone in an emergency ................................................................................... 14
Moving and handling equipment .......................................................................................... 15
Managing risks when moving equipment ......................................................................... 15
General principles for moving ........................................................................................... 17
Managing risks in different situations ............................................................................... 18
Safe manual handling techniques ..................................................................................... 20
Healthcare waste ................................................................................................................... 23
Keeping yourself and others safe ...................................................................................... 25
Workplace safety ................................................................................................................... 26
Hazards .............................................................................................................................. 26
Workplace security ................................................................................................................ 28
Managing unwanted behaviour ............................................................................................ 29
What is de-escalation? ...................................................................................................... 30
Violence ............................................................................................................................. 30
Transporting body parts ........................................................................................................ 37
Code of Rights .................................................................................................................... 37
Respecting cultural and religious beliefs ........................................................................... 38
Staying safe ........................................................................................................................ 38
Working with people who are deceased ............................................................................... 39
Cultural and religious beliefs around death ...................................................................... 42
Transferring the deceased person ..................................................................................... 47
Viewings ............................................................................................................................. 47
Working as an orderly (US 27315, 27317, 28530, 28531, 28532, 28533, 28534, 28549) Learning Guide © Careerforce – Issue 1.0 | May 2015
Working as an orderly (US 27315, 27317, 28530, 28531, 28532, 28533, 28534, 28549) Learning Guide © Careerforce – Issue 1.0 | May 2015
Introduction
This learning guide is about working as an orderly. It includes a number
of different tasks that you may carry out as part of your work as an
orderly. This learning guide covers learning for eight different unit
standards.
As the tasks of an orderly can vary in different workplaces, you may not
have to perform all of the tasks described in this learning guide or
complete all the relevant unit standard assessments.
Check with your trainer if you are unsure which unit standard
assessments you will be completing as part of your qualification.
How to use your learning guide

This guide supports your learning and prepares you for unit standard
assessments. The activities and scenarios should be used as a general
guide for learning.
This guide relates to the following compulsory unit standards:
• 28530 Move and store equipment in a healthcare facility (level 3,
7 credits).
• 28531 Transport people in a healthcare facility (level 3, 5 credits).
• 28534 Support the effective functioning of a healthcare facility as an
orderly (level 3, 5 credits).
This guide relates to the following elective unit standards:

• 27315 Describe and implement strategies for de-escalating
unwanted behaviour in an aged care, health or disability context
(level 4, 3 credits).
• 27317 Prepare a deceased person for viewing when working as an
orderly in a health or disability context (level 3, 3 credits).
• 28532 Transport a deceased person in a healthcare facility (level 3,
5 credits).
• 28533 Transport body parts in a healthcare facility (level 3,
5 credits).
• 28549 Collect and transport healthcare waste in a healthcare facility
(level 3, 3 credits).
This guide is yours to keep. Make it your own by writing notes that help
you remember things, or where you need to find more information.
Follow the tips in the notes column.
You may use highlight pens to show important information and ideas,
and think about how this information applies to your work.
Working as an orderly (US 27315, 27317, 28530, 28531, 28532, 28533, 28534, 28549) Learning Guide © Careerforce – Issue 1.0 | May 2015 1
You might find it helpful to talk to colleagues or your supervisor.
Finish the relevant section of the learning guide before you start on
each assessment.
What you will learn

This topic will help you to:
• understand your role as an orderly.
• move people and equipment.
• work with people who are deceased.
• transport waste and perhaps body parts.
• manage unwanted behaviour.
What you will need

To complete this topic, you will need:
• this learning guide. More info
• your trainee assessment for this topic. If you have a trainer,
• forms from your workplace, such as: they should give you
• accident/incident reports. all the forms that you
need for these topics.
• the people you support.
• you!
Your role as an orderly
Orderlies are an important part of the healthcare team. Orderlies may
have a range of responsibilities including moving people and
More info
equipment; keeping the healthcare facility clean; and assisting other
staff members when there is an emergency or unwanted behaviour. This section of the
learning guide will
A day in the life of an orderly help you complete
the compulsory unit
You may do many different tasks in a day at work. Some of the tasks
standard assessment
are: for 28534 Support
• transferring people. the effective
• collecting and delivering clinical records. functioning of a
healthcare facility as
• moving equipment, like scanners and pumps. an orderly. There is
• collecting general and hazardous wastes. more information
• replacing medical gases. about this unit at the
back of this learning
• collecting dirty linen, like bed sheets. guide.
• assisting the mortuary.
• assisting with emergency incidents, like attending codes.
• collecting specimens.
• delivering flowers to people.
• assisting with lifts, turns and slides of people.
Write
What is a typical day like at work for you? Write down a list of the tasks More info
you might do in a day.
A person means
someone accessing
services. Other terms
used for the person
may include client,
consumer, customer,
patient, individual,
resident, service user,
turoro, or tangata
whai ora.
Working as part of a team
One of the most important tasks for an orderly is working well as part of
the healthcare team.
It is very important that you:
• have a professional, helpful and friendly manner at all times.
• communicate regularly with your supervisor.
• communicate information needed by your team clearly during your
shift and at handovers.
Your team
Here are some of the people you may work with as an orderly.
• Supervisor – in many healthcare facilities, your supervisor is the
person who will let you know what you have to do and who you will More info
report to. This means if someone goes wrong, they are the first
person you should tell. A supervisor is the
person you report to
• Transit care nurses – sometimes a person will need to have a nurse
at work. Supervisors
accompanying them when they are being moved. This nurse will be
may have different
responsible for the medical care of the person.
names in different
• Other staff – you may need to help other staff. For example, you workplaces, such as
may need to assist by collecting and delivering a crash trolley or manager, charge
stretcher in an emergency. You will also need to communicate with orderly, shift
the ward staff when moving people. supervisor and/or
dispatcher.
Write
Who do you work with? Who do you report to?
Supporting your team
There are many ways you support your team as an orderly.
Handovers
Your workplace will have a set process for handovers.
More info
When you move someone from one place to another you should do a
handover with staff both before you leave and when you arrive. A handover is when
Handovers are important as other staff need to know that the person is the responsibility for
being moved, and where they are going. Having a handover ensures the care of a person
that you know about any items or records you have to take and any is given from one
other important information. staff member,
department, ward or
When you arrive, you should let staff know the person is there, and any shift to another staff
other important information you think they should know (for example, member,
if they were upset during the transfer). department, ward or
shift.
Support with tasks
Other staff may ask you to assist them with moving people onto a bed
or wheelchair. If this is part of you role, make sure you know how to
assist with lifts, turns/rolls and slides safely. Talk
You may also be asked to collect and deliver pieces of equipment. This
Talk to your trainer, if
may have to be done quickly in an emergency. you aren’t sure about
the handover process
Support with challenging behaviours in your workplace.
Depending on your workplace policies, you may have to help other staff
when someone is agitated or violent.
In other workplaces, you may just need to phone for security if
someone is agitated or violent. Make sure you remember the number
to call.
There is more information about how to support people who are
behaving in a challenging way in the section on ‘Managing unwanted
behaviour’.
Boundaries of your role
Boundaries are to keep people safe – including yourself, the people you
look after and other staff.
Boundaries are an important part of being professional in your
workplace.
Boundaries can be seen as a continuum: you can be under-involved or
over-involved with the care of the people you look after.
Under involvement Good boundaries Over involvement

Think about
Being cold towards the Being friendly Being friends with the
people you look after people you look after What boundaries do
Being disinterested in Being courteous Asking personal or you have that keep
the people you look inappropriate questions the people you work
after with, other staff, and
yourself safe? If you
Neglecting the people Being respectful of Flirting with the people don’t know, ask your
you look after people’s cultures you look after trainer what they are.
Being rude or offensive Respecting people’s Giving your personal

towards the people you rights and treating details to people you
look after people with dignity look after so they can
call you at home
Not thinking about the Putting safety of the Not wearing gloves and
safety of the people people you look after masks when you should
you look after first
Ignoring the people you Keeping private Telling friends about

look after information personal details of
confidential people you look after
Being careless with Taking care of Taking work equipment

equipment equipment home
Not doing your job Making sure you Performing tasks

properly understand your role outside your role and
and complete all tasks knowledge
Not doing all the tasks Asking your supervisor Giving health advice
you should for your role when you don’t know
something
Looking after people
It’s important for you to take great care of the people you look after. Think about
How do you care for

Greetings
the people you work
A friendly greeting can make a big difference to someone who is feeling with?
scared or worried. Introduce yourself to the people you look after when
you first meet them. Find out and use their preferred name and/or title
and name. This will show them that you respect them, and see them as
a person.
Offering assistance
You can offer assistance. For example, check to see if the person you
are looking after is warm enough. If they are not, you could give them a
blanket.
Supporting people who need special assistance

Sometimes the person you may look after may need special assistance.
For example, they may struggle to get into a wheelchair. Ask if they
would like help, and assist them as required.
Sometimes you may need to use special bariatric wheelchairs or beds if
people are very big. Make sure you know where these are and the
processes around using these in your workplace.
Providing a service
The services you provide help to ensure people’s comfort and safety.
For example, think about:
• moving someone to a new place and then making sure the brakes of
the bed are on.
• helping the person to lower or adjust their bed so they are
comfortable.
• putting bed side rails up, if these are required.
• offering extra blankets or pillows, if they will help make the person
more comfortable.
• giving people their buzzer or call bell, so they can call for assistance.
• taking care of their belongings by packing their bags carefully and
checking they have everything, like their mobile phone.
Providing advice on healthcare facilities
Healthcare facilities can be confusing places. As an orderly, you will
probably know your way around the hospital really well. People may ask
you the way to different parts of the healthcare facility. You can help
them by giving them directions or guiding them, if they are confused.
Respecting and being aware of the person’s culture

It is important to be aware of the cultural beliefs of people you support.
This will help them feel more comfortable at a time when they might be Talk
feeling scared and vulnerable.
Depending on the policies of your workplace, it may be appropriate to Talk to your trainer
ask people who are being moved on a bed which way they would like to and ask about any
be pushed: head first or feet first. important cultural
beliefs that you need
Māori people may wish to be pushed head first, as deceased people are to be aware of
traditionally carried feet first. By giving the person the option of which
way they are pushed, this shows respect for their cultural beliefs.
Many cultures have specific beliefs about how the body is treated as
well as death and spirituality. These things can be important to consider
in a health care facility.
The Code of Health and Disability Services Consumers'

Rights
All people receiving care from a health or disability service have rights
under The Code of Health and Disability Services Consumers' Rights.
This is often called the Code of Rights. Knowledge of these rights and
understanding how you can respect these rights in your work as an
orderly is important.
Here are the Rights under the Code of Rights:
• Right 1: the right to be treated with respect.
• Right 2: the right to freedom from discrimination, coercion,
harassment, and exploitation.
• Right 3: the right to dignity and independence.
• Right 4: the right to services of an appropriate standard.
• Right 5: the right to effective communication.
• Right 6: the right to be fully informed.
• Right 7: the right to make an informed choice and give informed
consent.
• Right 8: the right to support.
• Right 9: rights in respect of teaching or research.
• Right 10: the right to complain.
Write
Choose two of the rights from The Code of Rights and write about what
you do to honour these rights in your work with people.
For example, Right 6: The right to be fully informed:
‘I make sure I introduce myself to people I am moving and tell them
where they are going.’
First right:
Second right:
Transferring people
One the main tasks of orderlies is to move people to different places in
the healthcare facility. This is often called transferring people.
More info
Communication This section of the
Communication is important when you move people. learning guide will
help you complete
You need to communicate with other staff and the person who is being the compulsory unit
moved. You will need to: standard assessment
• check with the dispatcher the name/details of the person. for 28531 Transport
people in a
• inform the ward clerk or staff that you are moving the person and let healthcare facility.
them know where the person is going.
• make sure the transit nurse or anyone accompanying the person
(like a parent of a child being moved) is available, if required.
• introduce yourself to the person you are moving and tell them
where they are going.
Risk assessment
It’s important to think about any risks before moving someone.
Think about
Talk to the ward staff, and work out the best way of transporting the
person. Options for transport may include: Do you know about
• wheelchairs. the different types of
wheelchairs, beds,
• beds. and trolleys in your
• trolley/stretchers. workplace? Do you
• special bariatric wheelchairs or trolleys. feel confident using
them all? Do you
Your healthcare facility may have several different types of wheelchairs, know how to use all
beds and trolleys/stretchers. Make sure you know how to use each one of the safety features
and where special ones are kept. for each type of
equipment? If you
It’s important to know how to use each mode of transport safely. For don’t, ask your
example, when you are moving people on beds, you should know how trainer what to do.
to use bed rails.
Some people may need extra medical or emotional support when they
are being moved. They may need to be accompanied by a transit nurse.
While this will depend in part on your workplace’s policies, here are
some people that may need a transit nurse, for example: Think about
• people with a suspected spinal injury.
Do you know what to
• children under 10. do if a person you are
• people receiving some types of drug infusions through an IV. moving has an
• people who are confused and may harm themselves or others. infectious disease? If
you don’t, ask your
• people who are in the middle of a blood transfusion. trainer what to do.
Other people may have a disease that is infectious and special actions
may need to be taken. These are likely to include wearing a mask,
gloves, and special clothing and correctly disposing of these, according
to your workplace processes after use.
If you ever have safety concerns about the person you are moving, you
can ask your supervisor for a ward staff member to accompany you.
Verifying you have the correct person

It’s also important that you check the identity of the person you are Think about
moving.
How do you check a
Your workplace will have a procedure for this, but it may include: person’s identity
before moving them?
• checking with your dispatcher which person is to be moved.
If you don’t know, ask
• checking the person’s identification wristband (or other your trainer what to
identification device) and hospital number. do.
Patient care items and personal effects

You will also need to identify patient care items and personal effects
that must be transported as well.
Patient care items are pieces of equipment related to the person’s
medical care. Patient care items may include:
• a trauma trailer unit.
• pumps and syringe drivers.
• fluids.
Personal effects are the belongings of the person being moved. If the
person is being moved to another ward, you will need to make sure you
have all their personal effects and these are moved with the person.
These may include their:
• mobile phone.
• clothes.
• shoes.
Transporting people’s medical records
Medical records are an extremely important part of patient care.
As an orderly, you should never read any medical notes about a person
or discuss these records with anyone. This helps to protect people’s
privacy and shows respect for them.
Normally you will bring medical records when a person is being moved.
If you do this, don’t give the person their medical notes to read. If the
person wants to read their records, tell them that they must speak to a
nurse about this first.
It’s also important you don’t give the person any medical advice.
Sometimes people can be confused about roles and may think you are a
doctor or nurse. If they ask for medical advice, it is best to remind them
of your role as an orderly and help them to ask a nurse instead.
When wards or departments need a person’s medical records, an
orderly will often collect and deliver these records.
Depending on the procedures of your workplace, these may be placed
in a Clinical Records Transit bag, which helps protect a person’s privacy.
Safety guidelines for transporting items

It’s important that you transport any patient care items and/or personal
effects safely.
Your workplace will have processes around:
• how items will be carried (for example, personal effects might be
placed in a patient property bag).
• where items are placed.
• whether a transit nurse is required (for example, when the person is
receiving IV fluids).
Write
When is a transit nurse needed in your workplace? List at least three

situations when a transit nurse is required when moving someone.
1
Maintaining the dignity and safety of the person being
moved
A good rule is to move a person how you’d want to be moved yourself
or have a family member moved.
Think about the person’s privacy. Because hospital gowns are
sometimes short, it is a good idea to offer the person a blanket to cover
themselves with, if they wish.
Completing the transfer

When you arrive at the destination, let the ward clerk or nurse know
that the person has arrived in their ward/department.
If there have been changes in the person’s condition while they have
been transported, tell the ward clerk or nurse about these. An example
of this would be if the person said they felt dizzy or was in pain.
Make sure you give any medical records to the ward clerk or nurse.
There may be other administration requirements, depending on your
workplace.
It’s also important to make sure you are leaving the person safe and
comfortable.
You can do this by:
• putting the brakes on their bed.
• lowering their bed and/or helping them to adjust their bed to their
requirements.
• asking if they are warm enough, and if they are cold, getting them a
blanket.
• giving them their buzzer or call bell so they can call for assistance.
Moving someone in an emergency
When moving someone in a medical emergency, it is important to move
them in both a timely and safe manner.
Think about
Your workplace will have guidelines about moving people in
emergencies. Do you know what
cases are considered
emergencies at your
workplace? Do you
Write know how to move
someone in an
What should you do when moving someone in an emergency? emergency? If you
don’t, ask your trainer
what to do.
Moving and handling equipment
One of your roles as an orderly is to collect and deliver pieces of
equipment. These may include:
• empty beds. More info
• empty wheelchairs.
This section of the
• empty stretchers or trolleys. learning guide will
• medical gases. help you complete
• emergency medical care items like Lifepak, clinical emergency the compulsory unit
trolley/crash cart, airways box, CPR case. standard assessment
for 28530 Move and
• medical machines like ECG machine, bladder scanner, dialysis store equipment in a
machines, pumps. healthcare facility.
• other emergency items like a fire resource pack.
• your portable RT.
It’s important that you know where to find the equipment, especially if
it is needed in an emergency. It is also important that you know how to
move it safely and with care, so you don’t get hurt (or hurt someone
else) and the equipment isn’t damaged.
Managing risks when moving equipment

Lifting and moving objects and equipment can lead to injuries and it is
important that you look after yourself. You need to take care of your
Think about
back and keep fit.
When carrying out tasks that involve moving loads (equipment and/or What sorts of
people) you need to be aware of the safety of yourself and others at all equipment and items
times. do you move at
work?
Under the Health and Safety in Employment Act 1992:
• it is the employer’s responsibility to provide a safe working
environment.
• it is your responsibility to take all practicable steps at work to ensure
your own safety and the safety of others.
LITE Principles
One way you can think about the risks when moving equipment is to
use the LITE principle.
LITE = Applying the LITE principles will

enable you to:
•
Load plan the task, check the
environment, assess the risks
and identify any hazards.
Individual • prepare for the task – minimise
hazards, get any equipment,
prepare the people.
Task • apply safe bio-mechanical
principles of posture, position
Environment and technique.
Load - Characteristics of the equipment or object being moved can

affect the handling risk. Consider its weight, shape, size, surfaces, and
edges.
Individual - This is about the capabilities and training of the orderly. For
example, age, fitness level, size, fatigue, knowledge and training.
Task - This relates to the nature of the task, ie, what has to be done. It
may require moving a bed through a narrow corridor, carrying laundry
or a heavy piece of equipment. Consider the best handling method that
will be needed, for example: pushing, pulling, or carrying.
Environment - This relates to the work environment, the space available
for moving or transferring, the layout of the working area, the
brightness of the lighting and the type of flooring surface. Before
moving, check access ways are clear and that the destination is ready,
for example, the bathroom is unoccupied. Check for hazards, such as
furniture in the way, wet and/or slippery floors, uneven surfaces or
steps, or tripping hazards like electrical cords and loose mats.
Some equipment or objects may be over-sized or very heavy. These
objects may cause injury if you try to lift or carry them in an unsafe way.
If something is too heavy to lift by yourself, get someone else to help
you to lift it. Where possible, use aids and equipment to move or
transfer heavy items. Follow the manufacturer’s instructions for
equipment use.
General principles for moving
It is important to apply safe bio-mechanical principles of posture,
position and technique so you can minimise the risk of harm to yourself
and any other person.
Always bend your knees, not your back. This may mean sticking your
bottom out!
Never bend and twist at the same time.
If moving heavy objects/loads, always have them close to your body.
When moving and handling objects and loads:
• make sure your grip is stable.
• maintain a good posture and spinal alignment.
• push rather than pull wherever possible.
• utilise your body weight, using your whole body, not just your arms.
• move your whole body when changing direction.
• keep your line of vision clear.
• stay focused on your task.
Make sure that before you move or transfer anything that your path is
clear and the destination is ready.
If you need help with the moving task, make sure you get the help you
need. Work with others where possible.
If it is difficult, find another way, for example:
• use a trolley.
• use assistive equipment.
• use moving equipment.
• get another person to assist you.
• re-pack items to reduce the weight and size for easier
moving/transferring.
Managing risks in different situations
There may be also challenges caused by where you have to move
objects or equipment. It is important to think about your safety, the
safety of others, and to make sure the equipment is not damaged.
Talk with your supervisor if you are ever unsure about moving
equipment or objects.
Situation and risks Staying safe
Oversized objects may be awkward Make sure you can see over the
to carry. They may make it hard to object.
see. Ask another orderly for help, if you
need to.
Overweight objects may cause a If it feels heavy, it is heavy.
back injury or strain. Ask another orderly for help.
If they are too heavy you might also If it is something that can be split
drop it, which might result in injury into several smaller loads, do this.
or damage to the equipment. Where possible, use aids and
equipment to move or transfer
heavy items. Follow the
manufacturer’s instructions for
equipment use.
Stairs can cause you to trip and fall. Work out if you can go a different
Your balance is different when you way.
are carrying something and it is easy Make sure you can see your path
to misjudge the height of the steps. clearly.
Check the stairs for worn patches or
places you may trip or slip.
Move as slowly as you need to.
Lifts have a maximum load capacity If the equipment has brakes, you
and may be unsafe if they are may want to use them when you are
overloaded. There is a risk of injury in the lift.
to other people if they travel in the Check the weight capacity of the lift.
lift with you and the equipment Do not overload the lift.
moves. There is also the chance of Sometimes healthcare facilities may
injury when people try to get in the have a special lift for moving
lift before you exit. equipment. Use this if this is
available.
Watch for people trying to enter the
lift when you are moving the
equipment out of the lift.
Confined spaces make it hard to Make sure you can see your path
bend safely and it is easy to damage clearly.
the equipment or trap your fingers Watch your head and fingers, and
or other body parts. move carefully.
Think about the best way of moving
the item and clear the path for it as
much as possible before starting to
move it.
Public areas have many potential Make sure you can see your path
difficulties. People may get in your ahead clearly.
way and be injured or cause damage Move slowly so people can move
to the equipment. Sometimes out of your way.
people may try to fiddle with the Be ready to stop.
equipment or attempt to steal it.
Keep a close eye on the equipment
at all times.
Narrow access ways can be tricky to Clear any objects out of the way.
navigate. The equipment may be Move carefully and make sure you
damaged against the wall or your can see your path clearly.
fingers might get crushed. If you have to, angle the equipment
to move through the access way,
and/or ask for help from another
orderly.
Move slowly so you don’t damage
the equipment or get crushed.
Safe manual handling techniques
Here are some guidelines for moving your body safely when you are
lifting.
Stand in a stable position.

Your feet should be shoulder
distance apart.
The circle gives you a safe and

stable base to work in.
Moving out of this circle can put

your safety at risk.
Avoid twisting.
Keep your feet pointing in the
direction of movement. This is the
step-stand position.
Make sure your shoulders and

pelvis stay in line with each other.
This will avoid twisting your back.
Bend your knees slightly.

Maintain your natural spinal curve.
Avoid stooping by bending slightly

at the hips (bottom out).
Keep your elbows tucked in
Keep the person or equipment
close to your body.
Avoid reaching - the further away

from you the load is, the greater
the potential for harm.
Tighten your abdominal muscles

to help support your spine.
Keep your head raised.

Keep your chin tucked in.
Head, shoulders and hips should all

be facing in the same direction.
Move smoothly throughout the

technique and avoid fixed
holds.
Move upper and lower body as one
unit to avoid twisting at the waist.
When you reach down, make
sure your knees are bent and
your back is straight.
When you lift up, push down
through your heels and keep your
back straight so that your leg
muscles can do the work.
When you are lifting or carrying

things, try not to twist your
body.
Twisting puts too much strain on
your muscles and joints.
Your organisational procedures

It’s very important you know the procedures and processes around
moving different types of equipment.
These may include:
• where you collect the equipment from.
• the best way of moving the item.
• safety features, such as brakes, on the equipment.
• how to clean the equipment.
• how to store the equipment safely.
It’s also important you know how to report faulty equipment, and what
to do with it.
Healthcare waste
Some orderlies are responsible for keeping their workplaces clean and
collecting, segregating, and transporting waste. Other orderlies are not
More info
responsible for this, but will report issues around waste to cleaning
staff. In either case it is useful to have some knowledge of your Segregating means
workplace processes around different types of waste to keep yourself keeping apart or
and others safe. separate. It’s very
important to keep
Know your waste hazardous
There are many different types of waste at a healthcare facility. (dangerous) waste
out of the general
Contaminated waste is rubbish that has something on it that could waste.
make you ill. The rubbish could be contaminated with chemicals or
poisons, germs, or infected human products. Examples of contaminated
waste include a tissue, a paper towel with blood on it, half-eaten food, a More info
used plaster.
Contaminated waste is sometimes called ‘hazardous waste’, which This section of the
includes other waste as well. Hazardous waste examples include soiled learning guide will
items, human products like blood and body fluids, sharps, clinical waste, help you complete
cytotoxic waste, mercury, and radioactive wastes. the elective unit
standard assessment
In hospitals, items coloured yellow show that something is hazardous or for 28549 Collect and
contaminated. For example; hazardous waste bags are usually yellow. transport healthcare
Contaminated linen bags are yellow. Contaminated and hazardous waste in a healthcare
wastes must be put in yellow colour coded bags. They must not be put facility.
in with general waste or rubbish.
Other wastes, such as recyclables and general waste are
non-hazardous.
Sharps
Sharps are just what they sound like – anything sharp. This includes
needles, scalpel blades, broken ampoules and pipettes.
Use something to pick up the sharps, for example, tongs or forceps. Do
not use your bare hands.
Sharps container
Anything sharp enough to
penetrate skin, for example, a
needle, has to be disposed of in a
yellow safe ‘sharps’ container.
Needles Scalpel blades
Ampoules
Pipettes
Clinical waste
Clinical waste may contain blood or other body fluids. It should be
treated as a hazardous waste as blood and body fluid can carry diseases.
Cytotoxic waste
Cytotoxic waste is a by-product of particular cancer drugs and can be
very dangerous. Sharps contaminated with cytotoxic waste are put in a
cytotoxic sharps container separate from other sharps.
Mercury
Mercury is used in the production of thermometers and if they break it
can cause problems as it is poisonous. There is a special mercury spill kit
which must be used.
Radioactive waste
Radioactive waste comes from the radiology or nuclear medicine
department and should not be removed from this area.
Recyclable material
Recyclable material is just the same as you would have at home and
includes paper, some plastics, aluminium cans and cardboard.
General waste
This is all the other waste produced at the health care facility. It is
important that other waste doesn’t become mixed with general waste
as each has its own rules around disposal. If the wastes are mixed for
any reason this should be reported to a senior staff member.
Keeping yourself and others safe
To keep yourself and others safe:
• never put your hands into any container of waste of any sort – you
don’t know what’s in there.
• wear gloves when handling waste.
• always carry a bag of waste away from your body as it might contain
a sharp item. For the same reason, don’t squeeze the air out of a
rubbish bag.
• always leave sharps, cytotoxic or clinical waste in approved locations
(never in a compactor).
• never put waste down a laundry chute.
• never put clinical waste down a waste chute.
• always wash your hands after removing your gloves.
Personal protective equipment

It is important to wear the correct PPE when working with any
dangerous substance. Protective clothing and equipment is the last line
of defence – it only minimises the potential for harm rather than
eliminating it. Wear PPE correctly and ensure it is in good order. This is
your responsibility.
For instance, you should always wear gloves when handling rubbish and
you should always wash your hands after you have taken off the gloves.
PPE might include:
• safety glasses.
• protective clothing.
• gloves.
• footwear.
• masks.
Workplace safety
There are a number of tasks you have as an orderly that help keep the
healthcare facility safe and secure. You should:
More info
• practice safe work habits.
• look for unsafe work situations and make them safe, or inform a This section of the
supervisor. learning guide will
help you complete
• use personal protective equipment correctly.
the compulsory unit
• report hazards, incidents, accidents and near misses. standard assessment
• report faulty equipment. for 28534 Support
the effective
• be ready to help in emergency situations.
functioning of a
healthcare facility as
an orderly.
Hazards
There are three ways in which you can respond to hazards.
The first way is to try to eliminate the hazard. This means get rid of the
hazard. For example, if there was broken glass on the floor, you could More info
eliminate this hazard and report this to your supervisor.
If you can’t eliminate the hazard, you should try to isolate it. This means A hazard is
separating it from people who it might harm. For example, hazardous something that is
dangerous and could
waste is disposed of separately to general waste.
potentially cause
Lastly, if you can’t eliminate or isolate the hazard, you should try to harm.
minimise it. This means to make the hazard less of a risk. For example,
you can put a ‘wet floor’ sign up to warn people that the floor is wet. It could be:
If you are ever unsure about a hazard or how to respond to it, talk to • A wet floor, where
your supervisor. someone could slip
over.
Your organisation will have forms which you have to complete when
there is a hazard, incident, accident or emergency. • A broken piece of
equipment.
• A person who is
very angry and may
be violent.
Write
Here are some common workplace hazards you might come across.
Write down how you would respond to each hazard. If you feel unsure
about any, talk with your trainer about what you should do.
There is a trolley in the middle of the corridor.
Talk
Talk with your trainer

if you are unsure
what to do in these
situations.
A person you are transferring becomes agitated or violent.
You have to transport an oxygen bottle.
Workplace security
Another important role you have as an orderly is to help maintain the
security of the people you work with and the healthcare facility.
More info
Some of the ways in which you may do this are:
• being aware of what is happening around you. Suspicious behaviour
• being aware of the emergency number to call. is behaviour that
shows something
• reporting any unwanted or suspicious behaviour may be wrong or that
• reporting any suspicious or unattended objects. someone has a bad
• reporting any unauthorised visitors or media. intention.
• wearing correct uniform and ensuring your ID is displayed correctly. An example of

• following security procedures when entering or leaving secure areas. suspicious behaviour
is if you catch
• walking or transporting patients, staff or visitors to their cars at someone entering
night. people’s rooms when
• checking that doors that are supposed to be locked are locked. they shouldn’t be.
• completing incident forms for any incidents.
Write
What are your workplace procedures for making sure the people you
work with and the healthcare facility are safe and secure?
Managing unwanted behaviour
Being in hospital or a healthcare facility can be scary and frustrating for
some people. Feeling in pain, being confused, stressed, or frustrated
More info
and/or being under the influence of drugs or alcohol can lead to
someone becoming violent or behaving in an unwanted way. This section of the
Sometimes the people who you are looking after or their family and learning guide will
support people may behave in an unwanted way. help you complete
the elective unit
Unwanted behaviour is acting in a way that is socially or culturally standard assessment
offensive and inappropriate for a healthcare facility. Unwanted for 27315 Describe
behaviour will have a negative impact on a person or a group of people. and implement
It can be verbal behaviour, such as: strategies for de-
escalating unwanted
• swearing. behaviour in an aged
• making rude or insulting comments about someone’s ethnicity, care, health or
culture, religion, gender, or sexuality. disability context.
• making fun of staff or other people.
• trying to intimidate or making threats against other people.
• putting pressure on others.
• screaming or yelling at others.
• badgering.
Unwanted behaviour can also be physical, such as:

• standing too close or ‘standing over’ someone.
• touching someone inappropriately.
• hitting, punching, or biting someone.
• breaking items or equipment on purpose.
• throwing things.
In some workplaces, orderlies play a key role in managing unwanted

behaviour.
In other workplaces, this is not an orderly’s role. In these workplaces, it
is instead important to know what number to call if someone is acting
aggressively. Make sure you know what is expected of you in your
workplace.
You have two key considerations if you are responding to unwanted
behaviour. Firstly, the most important consideration is of safety – the
safety of other people and your own safety, as well as the safety of the
person who is behaving in an unwanted way.
Even if it is your role to manage unwanted behaviour, you should be
aware of your limits and when you need to call for back up. Make sure
you know the emergency number to call in your workplace.
The second consideration is the Code of Rights – both for other people
at your healthcare facility and for the person showing unwanted
behaviours. In general you should try to resolve the unwanted
behaviour in ways that:
• show respect for the person
(Right 1: the right to be treated with respect).
• keep their dignity and independence intact
(Right 3: the right to dignity and independence).
• communicate with them calmly
(Right 5: the right to effective communication).
• support them throughout the incident of unwanted behaviour
(Right 8: the right to support).
What is de-escalation?
When someone is acting in an unwanted way, your actions can make
the situation better (de-escalating the situation) or worse (escalating
the situation).
Violence
Recognising the risk of violence
In order to prevent a dangerous situation escalating, it is first of all
important to recognise the signs or risks that someone may become
violent1. Warning signs are when:
• the person appears agitated or restless.
• there is resistance to the suggested treatment or move.
• the person has assaulted a health worker within the past 12 months.
• there is a known history of threatening or aggressive behaviour.
• the person has made a threat of aggression directed towards people
or property.
• the person has friends or family members whose aggressive
behaviour may place staff or others at risk.
• there is a known history of drug or alcohol misuse.
• a medical condition is present that may cause the person to
misinterpret the environment or staff care activities(for example,
confusion, disorientation, delirium, acute hallucinations, delusions).
1
Forster J.A, Petty M.T., Schleiger, C and Walters H.C., Med J Aust 2005; 183 (7): 357-361. Know
workplace violence: developing programs for managing the risk of aggression in the health care setting
Conscious violence
Sometimes people can be violent without doing it on purpose.
Unconscious violence can result from a head injury or maybe a post-
operative response to anaesthesia. Conscious violence refers to
violence that is in response to a situation or as a result of the misuse of
drugs or alcohol.
Column 1 of the table below describes a variety of potential warning
signs or cues that may indicate that a person may be about to respond
violently. Column 2 describes suggested responses to each warning sign
that an orderly can use to try and diffuse the potentially violent
situation.
Warning signs of conscious violence2

Warning signs/cues of Responses that may help diffuse aggression
violence
Repeated series of Appear calm, self-controlled and confident,
questions confirming that you are addressing their
concerns.
Using another language in Identify language origin and locate interpreter
an aggressive manner to assist. A list of interpreters could be held in
an Accident and/or Emergency Department.
Using obscenities or Do not match their language.
sarcasm
Shouting Ask for information with a calm voice.
Replying abruptly or Calmly confirm the received information back

refusing to reply to the person.
Rapid breathing Breathe slowly and evenly.
Pacing Try to get them to sit down somewhere

comfortable.
Clenched fist or pointing Do not fold your arms or clench your fists in
fingers reaction.
Invading your personal Maintain a comfortable distance.
space
Staring Maintain normal, but broken eye contact.
Tight jaw with clenched Keep your hands open.

teeth
Shoulders squared up and Stand to the side.
dominating
2
Managing the Risk of Workplace Violence to Healthcare and Community Service Providers, Department of
Labour, NZ Government, 2009
De-escalation techniques3
Here are some guidelines to calm the situation down:
• Only one person should talk to the person who is being disruptive.
• Approach in an empathic, confident manner and avoid sudden or
violent gestures.
• Present yourself as being calm and in control, this is a powerful
de-escalation skill. Consider self-calming techniques – such as
slowing your breathing and counting to three.
• Have a non-aggressive stance with arms relaxed.
• Avoid prolonged eye contact, do not confront, and do not corner or
stand over the person.
• Emphasise your desire to help.
• Offer the person time to state their concerns; react in a
non-judgemental way explaining your desire to help sort out their
current difficulties. Focus on the here and now, and do not go into
long-term problems or issues.
• Attempt to work out the cause of the violent behaviour. Try to calm
the person by responding calmly and evenly. Do not become
aggressive or threatening in response.
• Some people will often settle if time is spent calmly discussing their
concerns and offering suitable support.
• Try to identify the problem and seek a solution.
• Encourage the person to think rather than act on the situation.
• Courtesies, such as offering a cup of tea (lukewarm), sandwich,
access to a phone, attending to physical needs, providing an
opportunity to rest, can be very helpful as is regular orientation to
place/person/situation.
• Getting relatives or trusted staff to talk with the person may help,
although they must be protected from attack. Be wary that the
presence of relatives may make the person’s behaviour worse.
• Do not touch the person without their permission to do so.
• Encourage the person to choose help such as agreeing to talk to a
mental health professional or accepting their medication voluntarily
(You could say for example, “It seems to me things are a bit out of
control. Will you let us help you? This medication will help you.”).
• If further intervention (such as medication) is required, having a
number of staff backing up the nominated clinician speaking to the
person (sometimes known as a show of force) may get the person to
co-operate. Only one person should lead and negotiate with the
person.
3
Mental Health and Drug and Alcohol Office, Mental Health for Emergency Departments – A Reference
Guide. NSW Department of Health, Sydney, 2009.
• If aggression escalates and violence seems close, withdraw from the
person and get help. If trapped, a submissive posture with eyes
averted, hands down and palms towards the person may help. If all
else fails, lift arms to protect head and neck, shout ‘NO’ very loudly
and try to escape.
The techniques described are important when dealing with a situation
on your own, but if possible always involve a nurse or other trained
professional.
Where the situation is rapidly getting out of control, you may need to
involve the mental health team.
Calm communication
We communicate with our bodies, facial expressions, tone of voice as
well as the words we use. Both verbal (the words we use) and
non-verbal communication (body language and tone of voice) should be
calm and non-threating or non-confrontational.
Write
For each of the following give examples of what would be ‘calming’ in

your non-verbal communication.
Non-verbal Calm
communication
Facial expressions
Tone of voice
Speed of speech
Voice volume
Posture
Gestures
Write
Give three examples of ‘calming’ words (expressions) you could use for
a distressed, aggressive person.
1
Active listening
Active listening is a strategy that demonstrates to the person that you
have heard what they are saying and have understood their message. It
includes listening carefully to what the person is saying and then telling
them what the message is that you have received. For instance they
could say “I don’t want to take my medication and you don’t have any
right to force me to. I have a right to decide what happens to my body.”
In reply you could say “So you are saying that you don’t want to take
your medication, is that correct?”
Having established that you have taken their message on board, you
need to be able to respond appropriately – for instance suggesting that
a doctor or other medical person be involved in the conversation to
explain why taking the medication is important.
Separation, removal or disengagement of participant(s)

If the person is a danger to others or themselves it may be necessary to
separate them from other people or members of the public. If it is a
safe option ask the person to go to a separate room, but ensure that
there is always an escape route handy so you don’t become cornered.
You also don’t want the person to feel cornered as this might aggravate
the situation.
If it is necessary to have the person removed, then back-up from
security staff is recommended.
Acknowledgement of feelings and/or needs

If the person is feeling frustrated or not in control, acknowledging and
empathising with their feelings can show respect and understanding.
For instance you could say “I know you have been waiting for a long
time and I know this is frustrating when you are feeling unwell, but we
have to attend to people on a priority basis.” Showing you understand
their situation is comforting and offers the person the opportunity to
explain the cause of their aggression more calmly.
Maintaining client watch4
Observing a potentially violent person involves regarding a person
attentively while at the same time trying to make them feel as though
they aren’t being watched. It also involves being ready to act if the need
arises. It can, therefore, be a very difficult task. As part of the ‘watching’
role it is important to maintain empathy, open communication and
being constantly alert without seeming to be nervous.
There are four level of observation:
1 General observation – knowing where the person is even though
they may not be within sight.
2 Intermittent observation – the person’s location is checked every 15
to 30 minutes.
3 Within eyesight – required when a person is a risk and needs to be
constantly within view.
4 Within arms-length – for high risk people who need to be kept close
at hand.
Calling for back-up

A key part of any job is to ensure you don’t put yourself at risk.
Although there is inherently some risk in an orderly’s role, it is your job
to ensure the risk is minimised as much as possible. If you are faced
with an aggressive person and you are unable to calm them down using
the techniques discussed, then calling for back-up is a responsible
choice.
Write
How do you signal you require back-up assistance at your workplace?
4
Safe and supportive observation of patients at risk. Mental Health Nursing “Addressing Acute Concerns”
Standing Nursing and Midwifery Advisory Committee, June 1999
Outlining boundaries of the situation
If the person is still able to think rationally, then discuss what behaviour
is acceptable, giving reasons why this is so. This should be done in a
quiet rational way.
You could say for instance “So no one takes offense, this hospital has a
policy of not allowing swearing. I hope you will understand that this is a
public space in which we need to show respect for all people.”
Outlining potential resolutions and/or pathways to a

solution
Offering options can often make an aggressive person feel empowered.
If the aggression stemmed from frustration and a sense of
powerlessness, then options which can address the frustrations will
help to diffuse some of the anger.
Breaking a large problem into manageable segments

If the person is angry about their overall health situation, it can be
useful to start by trying to solve a small frustration and then considering
other aspects of the bigger issue. This at least gives the person a sense
that there may be solutions for their other problems.
Use of a ‘third party’ to negotiate a solution

If the aggression has become personalised towards one person, it can
be useful to suggest another person intervene to find a ‘compromise’
which will diffuse the situation. Although family and supporters can be
useful in this role, it is also possible they will make the situation worse.
Transporting body parts
Body parts or biological tissue may be uplifted and transported by
orderlies as part of their job. Although many of these items may be very
small, they are part of a living or deceased person and, as such, must be
treated with respect. More info
Every healthcare facility will have policies and procedures related to This section of the
uplifting and transporting body parts (this includes biological tissue) so learning guide will
you will need to be familiar with the policies of your workplace. help you complete
Body parts can include: the elective unit
standard assessment
• limbs. for 28533 Transport
• body tissue. body parts in a
healthcare facility.
• placenta (afterbirth or whenua).
• organs.
Code of Rights
Talk
The Code of Health and Disability Services Consumers' Rights applies to
body parts and tissue too. The table below shows how you can honour Talk to your trainer, if
these rights when you are transporting body parts. you aren’t sure about
the processes for
transporting body
Right What you can do parts in your
workplace.
Right 1: the right to Body parts are seen differently by different
be treated with cultures and religions. By attending training and
respect. learning about different cultures and religions, you
will be able to show respect for different beliefs
around body parts.
Right 3: the right to It’s important to show respect for the privacy of
dignity and the person, and to treat the body part with respect
independence. and dignity. For example, don’t make jokes about
the body part or poke it etc.
Right 7: the right to The medical staff will discuss the options a person
make an informed or their family/whānau has for their body part so
choice and give they can make an informed decision. It’s important
informed consent. for you to carry out their wishes around what they
would like done with their body part.
Right 8: the right to Depending on the body part, there may be grief or
support. a sense of loss. You can show support for this loss
by treating the body part carefully and with
respect.
Respecting cultural and religious beliefs
Different cultures may have different views and practices around body
parts.
For example, in Māori culture, it is customary to bury the placenta
(called whenua) in a place where there is an ancestral connection.
In other cultures, placental encapsulation (where the placenta is made
into edible pills) is popular or becoming popular. Beliefs of other
cultures may seem extreme or strange at times, but show respect by
not making judgements or negative comments about the beliefs and
practices.
In many cases people or the family/whānau will be able to make a
choice about what happens to the body part. Some people or
family/whānau may wish to say a karakia (prayer) before the body part
is transported or disposed of.
It’s important to consider cultural beliefs too, in terms of storing body
parts. In the Māori culture, it is seen as very inappropriate to store body
parts in the same place as foods (or foods in the same place as body
parts).
Staying safe
Make sure you think of the safety of yourself and others and wear
appropriate personal protective equipment (PPE), like gloves, when
handling body parts. Follow your workplace’s processes for handling
body parts.
If the person is taking their body part home, it should be clearly labelled
and stored in the appropriate refrigerator. (This refrigerator should
never contain food or drink or medicines.) Make sure you know where
the correct refrigerator is and that the staff who need to know where
the body part is are informed in a handover.
Working with people who are
deceased
Dealing with death, deceased people and their families takes
understanding, empathy and thought. Deceased people are patients of
the healthcare facility and, as such, they and their families deserve
respect and dignity. They also have the same rights under the Code of More info
Rights as any person.
This section of the
Every healthcare facility will have policies and procedures related to the
learning guide will
treatment, movement and hand-over of deceased people. You will need help you complete
to be familiar with these policies and procedures for your workplace. the elective unit
As an orderly, you may have a role in transporting people who are standard assessments
deceased or preparing them for viewing by their family/whānau for 27317 Prepare a
members. deceased person for
viewing when
Showing respect for the deceased person and their working as an orderly
in a health or
family/whānau disability context and
There are some key ways in which you can show respect for the 28532 Transport a
deceased person and their family/whānau. It’s important to have some deceased person in a
understanding around the grieving process and the range of responses healthcare facility.
family/whānau may have to their loss. It’s also important to honour the
rights of both the deceased person and their family/whānau under the
Code of Rights and being aware and respectful of different cultural and
religious beliefs around death.
The grieving process

It’s important to have some understanding around the grieving process
and the range of responses family/whānau may have to their loss.
There is no ‘right’ or ‘wrong’ way to grieve and everyone will react
slightly differently. If you are ever concerned about a family member’s
reaction to the loss of their loved one, tell your supervisor or a nurse.
The following stages have been observed as quite common. The
following is adapted from the work of Elisabeth Kübler-Ross.
Denial and isolation

The first reaction to learning of terminal illness or death of a loved one
is to deny the reality of the situation. It is a normal reaction to
rationalize overwhelming emotions. It is a defence mechanism that
buffers the immediate shock. We block out the words and hide from the
facts. This is a temporary response that carries us through the first wave
of pain.
Cycle of grief stages
Anger
As the masking effects of denial and isolation begin to wear off, reality
and its pain re-emerge. We are not ready. The intense emotion is
deflected from our vulnerable core, redirected and expressed instead as
anger. The anger may be aimed at inanimate objects, complete
strangers, friends or family. Anger may be directed at our dying or
deceased loved one. Rationally, we know the person is not to be
blamed. Emotionally however, we may resent the person for causing us
pain or for leaving us. We feel guilty for being angry, and this makes us
angrier.
The doctor who diagnosed the illness and was unable to cure the
disease might become a convenient target. Health professionals deal
with death and dying every day. That does not make them immune to
the suffering of their patients or to those who grieve for them.
Bargaining
The normal reaction to feelings of helplessness and vulnerability is often
a need to regain control. People may say things like:
• “If only we had sought medical attention sooner…”
• “If only we got a second opinion from another doctor…”
• “If only we had tried to be a better person toward them…”
This is a weaker line of defence to protect us from the painful reality.
Depression
Two types of depression are associated with mourning. The first one is a
reaction to practical implications relating to the loss. Sadness and regret
predominate. The second type of depression is more subtle and, in a
sense, perhaps more private. It is our quiet preparation to separate and
to bid our loved one farewell.
Acceptance
Reaching this stage of mourning is a gift not afforded to everyone.
Death may be sudden and unexpected or we may never see beyond our
anger or denial. It is not necessarily a mark of bravery to resist the
inevitable and to deny ourselves the opportunity to make our peace.
This phase is marked by withdrawal and calm. This is not a period of
happiness and must be distinguished from depression.
Showing respect for the deceased person and their

family/whānau
There are two key ways in which you can show respect for the deceased
person and their family/whānau. These are honouring their rights under
the Code of Rights and being aware and respectful of different cultural
and religious beliefs around death.
Code of Rights
The Code of Rights also applies to people who are deceased and their
family/whānau. The table below shows how you can honour these
rights when you are working with people who are deceased.
Right What you can do
Right 1: the right to Death is seen differently by different cultures and

be treated with religions. By attending training and learning about
respect. different cultures and religions, you will be able to
show respect for different beliefs around death.
Right 3: the right to It’s important to show respect for the privacy of
dignity and the person, and to treat the person with respect
independence. and dignity. This involves following your workplace
guidelines, for example, around covering the
person’s body and using the correct linen.
Right 5: the right to The family/whānau may have questions they need
effective answered. The best way of helping the family is to
communication. ask a nurse to come and talk with them.
Right 8: the right to The family/whānau have lost someone they loved.
support. You can show support for this loss by giving them
as much time to grieve and be with their loved one
as they need during a viewing.
Cultural and religious beliefs around death
A person’s culture determines how death is handled and the different
requirements need to be respected at this difficult time in people’s
lives. The information on cultures comes from Careerforce‘s learning
guide for US 26979 about response to death.
The information on religion has been adapted from ‘A Practical
Reference to Religious Diversity’ which was developed by the New
Zealand Police as a resource for officers.
This is not a complete list of all the cultures and religions in New
Zealand. There will, of course, be differences between families
particularly when there is a mix of cultures. It is important, therefore, to
be respectful and considerate at all times and where ever possible take
the lead from the family and whānau. If in doubt, ask.
Christians
It’s important to treat the deceased with reverence and respect.
For Christians, death marks the beginning of a new relationship with
God. At the time of a death some Christians may want a priest or other
clergy-person to pray over the body before a funeral director removes
the deceased. In the Catholic Church the brief ritual of prayers over a
deceased person is called the Last Rites. The priest commends the
person’s soul into God’s care and prays for the bereaved.
After a death, a minister, chaplain, kaumatua or iwi liaison officer may
be asked to come and bless the room. This would usually be done as
soon as possible after the body has been removed.
Buddhists
It is best to leave the deceased in an undisturbed state for as long as
possible. It is advisable that a Buddhist monk or nun be contacted to
perform the necessary prayers.
The best way of handling the deceased person depends on the culture
and tradition of Buddhism of the deceased person. In Theravadan, the
body can be handled in a respectful way immediately. In the Mahayana
tradition it is best to leave the body undisturbed for up to eight hours.
Buddhism and Shinto are Japan’s two major religions, but usually
funerals are held Buddhist style for Japanese.
Buddhism also has the widest influence amongst Chinese. A person’s
eldest son or closest relative must be present at the time of death.
Chinese, Japanese, Tibetan, Vietnamese and Western Buddhists would
prefer to stay with the deceased.
Koreans
There are no known official statistics for North Korea as public religion is
discouraged. In South Korea religion is dominated by Buddhism,
Protestantism and Roman Catholics.
Korean family members want to be present during the last dying
moments of the person so that the deceased person does not become a
wandering ghost. Traditionally it was important that the person die at
home.
Hindu faith
Hindus accept death as an inevitable part of life. This acceptance is
based on a belief in rebirth or reincarnation. There is a decaying of the
body but a continuum of spirit. Death signifies that the soul leaves the
human body. The body is cremated (returned to dust) as soon as
practicable. Hindus see death not as a denial but an assertion of the
spirit, however, on a practical level, personal loss is still deeply felt.
A dying Hindu will want the presence of his or her family for comfort
and to recite the Hindu scriptures. People may call for a Hindu priest to
assist with their acts of worship and help them accept the death
philosophically. If the person is elderly he or she will want the presence
of their eldest son who will conduct the funeral service.
A Hindu family will usually want the body to go home at some stage,
usually after the body has been at the funeral parlour. Hindus are
usually cremated, except for children younger than three, who are
buried. Ideally the cremation should be within 24 hours of death.
Grief is expressed openly with physical gestures, the holding of hands
and embraces. These physical comforts are considered important for
those remaining.
Sikh faith
There are no specific protocols for the handling of the dead body, but it
must be given due respect.
The body should be handed over to the nearest family member a few
hours prior to cremation. This will allow sufficient time for the body to
be washed, dressed and to have appropriate prayers recited over it.
Cremation occurs with family members in attendance and the ashes
must be handed to the nearest family member.
Islamic faith (Muslims)
It is preferable to have a Muslim’s next of kin at the bedside before they
die. If this isn’t possible, a Muslim co-worker or visitor would be able to
read verses from the Qur’an (holy book) and encourage the dying
person to recite words of remembrance and prayer.
If the person dies in hospital, the body should ideally be cleansed of any
offensive smells by hospital staff. Proper ceremonial washing (ghusal)
will take place at the mosque by the next of kin. Males will wash the
male deceased and women will attend to females. The wrapping of the
body in sheets of clean, white cotton linen called kafan is important
The deceased is buried as soon as possible, ideally within 24 hours of
death. Sufficient time is allowed for mourners to pay their last respects.
Muslims believe that death represents the end of life on this world, but
eternal life is to come.
Jewish faith
After death, the body must be carefully and reverently prepared for
burial by the Jewish Burial Society, also called the Chevra Kadisha and
the Holy Brotherhood. The body is washed and immersed in water
called a mikvah and then dried. The body is wrapped in a shroud and
placed in a plain pine coffin. Burial is to take place promptly and is
generally carried out before nightfall.
Jewish tradition requires the body be watched at all times as the soul, it
is believed, does not leave until the burial. Once the Jewish Burial
Society becomes involved, arrangements will be made to have it
accompanied at all times.
Pacific culture
For Pacifica people, death and dying have deep cultural significance.
Whenever possible, it is best to ask the family about their preferences.
as Pacifica people come from a range of different cultural groups.
As death approaches, the family will want to be with the person and are
likely to want to spend time with the person after death. The family
may want to wash and dress the body themselves. The family should be
asked how the body should be moved and whether they wish to
accompany it.
Death is a time for the immediate and extended family to gather
together to perform the appropriate farewell ceremonies, which may
take several days and could be at a home or a church facility. Many
Pacifica people are deeply religious and regular church goers.
Māori cultural beliefs around death
Some important Māori concepts relating to death are discussed in the
table below.
Concept What you can do
Tangihanga refers to a It’s very important for whānau members and

funeral ceremony. friends to spend time with the deceased and for
the deceased person to be acknowledged and
remembered. You can help with this through
ensuring that the whānau can be with the
deceased as much as possible, including in the
viewing room and when the deceased is being
transported, if your workplace and the situation
allows this.
Wairua refers to It’s important to show respect for the spirituality of
spirituality, spiritual the deceased and their whānau by understanding
element, the soul, or and respecting the concepts of tapu (the sacred)
spiritual part of a and noa (the ordinary which diminishes tapu). For
person that exists example, a person who is deceased is tapu, and
beyond death. food is noa, so it is inappropriate to have food
around the deceased.
Whakapapa refers to Whakapapa is hugely important to many Māori.
genealogy and The loss of a whānau member, especially a
cultural identity. younger family member yet to have children, is
especially sad. Whānau can also include extended
family members. Understanding that a large
number of people may want to be with the
deceased and helping provide a suitable room
and/or multiple viewings for this shows respect for
the concepts of whakapapa and whānau.
Whenua refers to The land is an important connection for Māori, and
afterbirth, placenta, many prefer to be buried in places connected to
earth, land. their ancestors.
Hinengaro refers to Having an understanding of the range of emotions
the mind, intellect and reactions to grief, and being respectful of
and emotions these, provides support to the whānau.
The following guidelines were developed for the Auckland District

Health Board (ADHB) regarding how to deal with a deceased Māori
person.
• When death occurs the whānau should be notified immediately.
• Support staff involved in the care of the person (tangata māuiui),
such as the kaiatawhai, should be notified immediately.
• Whānau should be offered access to a phone to make arrangements.
• Staff should be guided by whānau on the cultural and spiritual
practices for them at this time.
• Where possible, whānau should have the choice of either taking the
deceased person (Tūpāpaku) home or contacting a funeral director.
• A single, private room should be allocated for the Tūpāpaku and
grieving whānau at the earliest opportunity.
• Whānau should be offered the choice of washing and dressing the
Tūpāpaku.
• Staff should allow time for whānau to grieve before moving the
Tūpāpaku. Whānau should determine the time needed in liaison
with staff.
• Food and drink should not be taken into the room.
• Staff should make every attempt to ensure a speedy release of the
Tūpāpaku.
• Before the Tūpāpaku is removed and in particular before a post
mortem, whānau should be given the opportunity and time to
exercise their beliefs and practices.
Moving the Tūpāpaku

• The wishes of the whānau should always be respected as to how the
Tūpāpaku is moved.
• The Tūpāpaku should always be wrapped in the allocated sheets.
Everyday linen must not be used.
• Whānau should be able to accompany the Tūpāpaku when moved.
• Staff should always handle the Tūpāpaku in a sensitive and
respectful manner.
• The Tūpāpaku should always be transported feet first.
• Transportation of Tūpāpaku should be conducted discreetly.
• All services should have a pre-determined ‘pathway’ for Tūpāpaku.
• Staff should ensure all linen, food cupboards, inpatient and staff
pantry and toilet doors are closed during the moving of Tūpāpaku.
• The movement of Tūpāpaku through public areas should be avoided
wherever possible. If not, staff should use the shortest route,
avoiding food and waste areas. This should be carried out in an
efficient, respectful and dignified manner.
• Staff should ensure that the designated lifts are used.
Following removal of Tūpāpaku

• Karakia should be performed in the room/area as soon as the
Tūpāpaku is removed
• The room should not be physically cleaned until karakia has
occurred.
Transferring the deceased person
Make sure that the person is identified before you move them. It’s
important to follow your organisational guidelines when moving the
deceased. There may be processes around the way you should go,
which lifts you can use, and what linen you should use to cover the
deceased person. It’s also important to listen to any special instructions
you are given for each person you transfer. For example, if the deceased
person is infectious you will have to follow your workplace policies
around this and wear the correct PPE.
You may have to transfer people who are deceased:
• from a hospital department or ward to the mortuary.
• to and from a viewing room.
• from the care of New Zealand Police, St John Ambulance or a
licensed funeral director to the mortuary.
• to the care of a funeral director.
• to the care of family/whānau or another approved person.
If you are transferring the person to the care of family/whānau, official

forms from the Department of Internal Affairs must be completed.
There may be other forms that are required, depending on your
workplace policies and processes.
Viewings
The viewing of a deceased person is always a very emotional time for
family and whānau. It is important to ease this process by being aware
of, and sensitive to, the cultural needs of the person and their whānau.
You must take into account their wishes for:
• where the person will be viewed - at their bed or in a viewing area.
• when they want to view the person and for how long they want to
be with the person.
• the number of people who may wish to view.
• the viewing of the person occurring more than once.
• any cultural considerations.
Preparing the viewing area and the deceased for viewing

Make sure the viewing room is clean and tidy and there are tissues and
enough chairs for the family/whānau available.
Make sure that the family/whānau have privacy and feel secure and as
comfortable as they can be at this time.
There may be viewing needs for other deceased people as well.
There may be a role for you in helping to prepare the deceased for
viewing. At some healthcare facilities, there will be a nurse taking the
lead role and you will be there to support the nurse to prepare the
deceased person for viewing.
Follow your workplace policies and processes.
Some of your workplace processes and policies may involve:
• cleaning the deceased person and dressing them in clean clothes.
• ensuring that appropriate clean linen is used and placed correctly.
• sensitively positioning the eyes and mouth.
• positioning the deceased with sensitivity on the trolley.
Write
What are the tasks you must complete in your workplace to prepare a
person who is deceased for viewing?

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Learning Guide

28530 Move and store equipment in a healthcare facility. Level 3 7 credits

28531 Transport people in a healthcare facility. Level 3 5 credits

28532 Transport a deceased person in a healthcare facility. Level 3 5 credits

28533 Transport body parts in a healthcare facility. Level 3 5 credits

28534 Support the effective functioning of a healthcare facility as Level 3 5 credits

28549 Collect and transport healthcare waste in a healthcare Level 3 3 credits

How to use your learning guide

This guide relates to the following elective unit standards:

What you will learn

What you will need

Who do you work with? Who do you report to?

Under involvement Good boundaries Over involvement

Being rude or offensive Respecting people’s Giving your personal

Ignoring the people you Keeping private Telling friends about

Being careless with Taking care of Taking work equipment

Not doing your job Making sure you Performing tasks

How do you care for

Supporting people who need special assistance

Respecting and being aware of the person’s culture

The Code of Health and Disability Services Consumers'

Verifying you have the correct person

Patient care items and personal effects

Safety guidelines for transporting items

When is a transit nurse needed in your workplace? List at least three

Completing the transfer

Managing risks when moving equipment

LITE = Applying the LITE principles will

Load - Characteristics of the equipment or object being moved can

Situation and risks Staying safe

Stand in a stable position.

The circle gives you a safe and

Moving out of this circle can put

Make sure your shoulders and

Bend your knees slightly.

Avoid stooping by bending slightly

Avoid reaching - the further away

Tighten your abdominal muscles

Keep your head raised.

Head, shoulders and hips should all

Move smoothly throughout the

When you are lifting or carrying

Your organisational procedures

Personal protective equipment

There is a trolley in the middle of the corridor.

Talk with your trainer

A person you are transferring becomes agitated or violent.

You have to transport an oxygen bottle.

• wearing correct uniform and ensuring your ID is displayed correctly. An example of

Unwanted behaviour can also be physical, such as:

In some workplaces, orderlies play a key role in managing unwanted

Warning signs of conscious violence2

Replying abruptly or Calmly confirm the received information back

Pacing Try to get them to sit down somewhere

Tight jaw with clenched Keep your hands open.

For each of the following give examples of what would be ‘calming’ in

Separation, removal or disengagement of participant(s)

Acknowledgement of feelings and/or needs

Calling for back-up

How do you signal you require back-up assistance at your workplace?

Outlining potential resolutions and/or pathways to a

Breaking a large problem into manageable segments

Use of a ‘third party’ to negotiate a solution