Teachable Moment

Flare, ASN, BSN

Sure, nurses do patient teaching all the time, but somehow there is a difference when you realize that you're no longer just teaching Mrs. Smith how to change her colostomy and you're now teaching ideals and concepts that you hope will carry a child through tumultous years of adolescence and the inevitable risk taking that goes along with being a young adult.

One afternoon, I paged through a catalog carrying various health promoting posters and gadgets. These catalogs are known to use shock value for older students by having such items as baby dolls that smoke and realistic looking lungs infected with realistic looking cancer. They have posters of grisly accident scenes and movies showing people actually in the throes of drug overdose. Several students came into the office for various complaints. High School aged students are pretty self sufficient for most minor injuries, but I still like to see what is going on with them so my charting can be accurate. I flopped the catalog onto my desk, open to the last page I was perusing and quickly tended to the tide of students, providing proper sized bandaids, a few ice packs, an inhaler for one student and determining for one student that he did not have ringworm, simply a flareup of his eczema.

When I turned back around, there was one student left. She had been sitting near my desk patiently. She was a diabetic student and was simply waiting to tell me her blood glucose and the amount of carbs she had for lunch so we could calculate her insulin dose together. She was browsing the catalog left on my desk while she waited.

"What was your sugar, Stacy?" I asked her.

"189, and 63 carbs." She replied, eyes still glued to the scare tactics sold in that calalog. "I know, it should be 2 units."

I calculated based on her orders and confirmed she was correct. She dialed the correct amount into her insulin pen, gave herself a shot and picked up the catalog again. She turned the page and her face twisted into an expression of shock. "Is this real?"

I glanced over her shoulder to find a poster showing a young lady that had been a model in the 80s who had made a decision to drive drunk. She had an accident and a second picture on the poster showed a horrifically mangled face. If it were not for the endotrachial tube, her face would have been impossible to landmark. The final photo on the poster showed the outcome of her survival. Alive, but horribly mangled; her modeling career was undoubtedly over, though her days as a cautionary role model were now well under way. I told my student that the photos were indeed real and the consequences of drunk driving could be even more serious than that. We then discussed the dangers of driving while drunk. I told her of a few instances from my life as a firefighter, cutting cars away from people in the middle of the night and then being their nurse the next morning on the trauma unit where I once worked. I made sure she knew how serious this could be.

Stacy dropped the catalog back on my desk and sat back in her chair. "Wow, I don't ever want that to happen." She said with a horrified expression on her face. She thanked me for explaining drunk driving to her and not "sugar coating" it and went on her way to class.

I sat down and pushed the catalog aside to chart the flood of students that had recently cleared my office. As the period bell rang, I finished charting the last student and began to focus my attention to a stack of immunization records that needed to be updated. Suddenly Stacy burst through my door leading two friends by their wrists.

"Can you please show them the poster?" She asked, wide eyed with a serious expression that she was rarely known the wear. With a nod, I slid a stack of health plans aside and revealed the catalog, the page with the poster was still face up.

The girls examined the small description of the poster while Stacy repeated what I had told her about drunk driving and even recanted some of my war stories.

"This is, like, something that doesn't usually happen though, right?" One girl looked to me nervously.

"Unfortunately, no." I replied. "This is the reality. This is what drunk driving looks like, that is if one is lucky enough to live through it."

They all stared in silence at the small ad for the poster in the catalog. One girl mindlessly reached up and touched her own carefully polished face. The message seemed to have gotten through.

I can't say that I use scare tactics frequently with students. I think if they are going to be used, there is a proper way to be effective. In this instance, the student deployed it on herself and then her friends and it seemed incredibly effective.

Teachable Moment

About Flare, ASN, BSN

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