Speaking 38

Roleplay Card 38

Interlocutor Role Play Card

Patient Setting: General Practice

You are the parent of a four-year old girl, who has just put her hand through a rusty nail whilst playing at the local park. Your child is very upset and does not want to receive the necessary tetanus injection.


  • Explain that it happened about 25 minutes ago at the local pork, when she picked up a plank of wood to ploy with. You removed her hand from the nail.
  • Say that you don’t want your daughter to receive the tetanus Injection now because it’s too stressful.
  • Explain that you forgot to bring him for her childhood vaccination and tell the nurse that you would prefer your partner to come after work to support you.
  • Reluctantly agree to your daughter having the injection.

Candidate Role Play Card

Nurse Setting: General Practice

You are the Nurse at a General Practice. A parent comes to see you with their four-year-old daughter, who has just put a rusty nail through her hand whilst playing at the local park. She needs to have a tetanus Injection Immediately but is distressed and refusing to have it.


  • Find out the details of the incident.
  • Explain that you need to clean and dress the wound and that she will need a tetanus injection.
  • Explain why the child needs the Injection immediately (did not receive it as part of childhood vaccination program, deep wound, foreign bodies present).
  • Persuade the parent to allow their child to have it now and warn about the potential risks of tetanus (fatal disease, causes seizures, muscle stiffness, lockjaw, difficult breathing).
  • Offer your support and reassurance.
  • After giving the injections, explain the rare and mild side-effects (feeling achy/tired, mild nausea / light-headedness).

Sample Role Play

Nurse: Good afternoon. Welcome to our practice. How can I help you today?

Parent: Good afternoon, nurse. My daughter had an accident at the park. She put her hand through a rusty nail.

Nurse: Oh no, I’m sorry to hear that. Could you tell me your name and your daughter’s name, please?

Parent: My name is Emma, and this is my daughter, Bless.

Nurse: Thank you, Ms Emma. How old is Bless?

Parent: Se’s four years old.

Nurse: Alright. Could you tell me what happened in more detail, so that we can go to the next best step?

Parent: Oh, yes. It happened about 25 minutes ago at the local park. She picked up a plank of wood to play with, and there was a rusty nail sticking out. She accidentally put her hand through it, you know. Yes, I removed her hand from the nail immediately but you see!

Nurse: That must have been very painful for him. I’m glad you brought him here so quickly. We need to clean and dress the wound to prevent any infection, and she will need a tetanus injection.

Parent: I understand, but he’s already very upset. I don’t want him to have the injection now because it’s too stressful.

Nurse: I understand that it’s a very stressful situation, especially for a young child. However, it’s crucial for him to have the tetanus injection as soon as possible. Since she didn’t receive her childhood vaccinations, she’s at a higher risk of developing tetanus. Tetanus is a serious condition that can cause severe muscle stiffness, seizures, lockjaw, and difficulty breathing. It can even be fatal.

Parent: I know it’s important, but she’s really scared of injections. I just don’t want to add more stress right now.

Nurse: It’s completely understandable that you’re worried about adding more stress to an already difficult situation. However, delaying the injection can be very dangerous. The sooner we administer the tetanus injection, the better it is for her health. I’ll be here to support you both through the process and will make sure it’s as quick and painless as possible.

Parent: I forgot to bring him for her childhood vaccination. I’d prefer if my partner could come after work to support us through this.

Nurse: It’s great that you want your partner’s support, but waiting might increase the risk of infection. I promise to be gentle and to take care of Bless. I can also provide some comfort measures to make the experience less stressful. Would it help if we talked about how we can make him feel more comfortable?

Parent: That might help. What do you suggest?

Nurse: We can use some distraction techniques, like showing him a picture book or playing a little game. We can also give him a small reward afterward for being brave. I’ll be here the whole time, and you can hold her hand and talk to him to keep him calm.

Parent: Alright, if it’s necessary, I agree to having the injection.

Nurse: Thank you for understanding. Let’s clean and dress the wound first. I’ll be very gentle, and it will help prevent infection. After the injection, there might be some mild side effects like feeling a bit achy or tired, mild nausea, or light-headedness, but these are rare and usually go away quickly.

Parent: Thank you for explaining everything and for your support.

Nurse: You’re welcome. Bless is in good hands, and we’ll get through this together. If you have any questions or need further support, please don’t hesitate to ask.

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Case Notes 38.1

Listening Part A 38.1