A Nation Of Nonreaders - page 5

I first noticed this serious problem when I was 19 years old and working at a grocery store. One of my coworkers, a middle-aged mother of three who had been married for 15 years, asked for my... Read More

  1. Visit  Sugarcoma profile page
    2
    Sadly this is something I am very familiar with. I worked in a large urban hospital in a city with a school system notorious for poor quality. Many of my patient's could not read. Many of them struggled with addition as well. It was maddening and made me both angry and sad at the same time. Patient education was often a laborious process. I learned quickly to stop using terms like hypertension, diabetes, and acid-reducer. Replaced with high blood pressure or high blood, sugar, and "this pill is for your belly so you don't get heartburn."

    One of our standard admitting questions was can you write and comprehend in English. I have never once had a patient answer no. Non-readers are often ashamed and very fearful to admit to their condition. Especially to the middle-aged white lady who they perceive as "one of them."

    I started to notice trends among patient's that clued me in to the fact that they could not read. Patient's who couldn't read would often ask me to wait and give consents/instructions, etc. to family members or friends. They would use multiple excuses "I am too tired, too sick, too overwhelmed etc. Many times they would become angry or act bothered when asked to fill out forms. Often times every interaction with them felt confrontational. Patient teaching became "just give me the stuff and let me go." They would hurry me, just give me the form and let me sign I already talked to the doctor about it etc. If you questioned their ability to read they would often get angry, ask for another nurse etc. Often times when given a form they would go straight to the line with an x. If the form did not contain a line with an x they would sign in odd places. They would often ask me to order lunch or breakfast for them. "Just get me whatever you think I would like nurse, I am too tired to deal with this right now."

    The best way to deal with a patient whom you suspect cannot read or is not comprehending is to take that out of the equation completely. Do not confront them and make them admit to it. Allow them to keep their dignity. If they want to confide in you they will. Don't force it. Never confuse an inability to read with intelligence. I got to the point where I would just assume every patient I had could not read or had comprehension issues.

    When I had forms that needed to be filled out I would take them into the room and sit down with the patient and ask them the questions. I would then point out where they needed to sign and give them copies of anything they signed so when a reading family/friend showed up they could look the form over. I would set up room service so that someone would call and take their order without their needing to ask. When giving instructions for anything new meds, discharge instructions etc. always give them their prescriptions seperately and tell them these are for your medications you need to give them to the pharmacy. Always, always make sure they know signs/symptoms to return for!!!!

    For teaching make things simple, allow them to lead you, and ask them to explain back to you. You will find out quickly if they need more information or not.
    alotusforyou and nguyency77 like this.
  2. Visit  Songbird,RN profile page
    1
    I had to laugh when I read your post!! We people in our 50's may have been using a computer for longer than you have been alive!! I guess I am an exception. Good laugh and I needed one today!!
    anotherone likes this.
  3. Visit  Paul'in'FL profile page
    1
    Quote from brillohead
    We watched this video in my Fundamentals of Nursing class. It's "long" (23 minutes) but was incredibly eye-opening for me. If you have the time, I highly recommend that you watch this video:

    Health literacy and patient safety: Help patients understand - YouTube

    As someone who was reading at a 12th grade level in the 5th grade, the concept of functional illiteracy was relatively foreign to me. Seeing this video, which shows regular everyday folks who can't read/understand their prescription instructions, hit me like a ton of bricks.

    This is a real problem in our society... one that I had no clue was so prevalent.
    I don't have time to look at the clip right now (school work for my MSN!) but I totally agree that it is hard to fathom illiteracy [functional or total] when my life situation is so far removed from the issue. I also was reading at age four, thanks to being the only child in a house full of adults. Someone always had the time to read me "one more story". Could not believe that those black squiggles on the white paper magically hid a story, and I was in a big hurry to crack that mysterious code. I was reading at a low college level by age 10, and still devour two books a week (for FUN, not for school).

    My seven year old nephew had books in his crib, and reads at a fourth grade level due to the exposure to books he gets from my brother and his wife. It really does start with the parents, and well before the child's first birthday.

    HALF the adults in the US functionally illiterate? That should be a crime.
    anotherone likes this.
  4. Visit  TheCommuter profile page
    0
    Quote from Paul'in'FL
    HALF the adults in the US functionally illiterate? That should be a crime.
    Not exactly. About 30 million adults in the US are functionally illiterate, which means they cannot read materials that are written at a fifth grade level. Another 63 million adults are what we'd call marginal literates because they read at or above a fifth grade level, but cannot comprehend material that is written at or above an eighth grade level.

    Together, functional illiterates and marginal literates are 93 million strong, which would comprise almost half of the adult population in the US.
  5. Visit  tinyonern profile page
    2
    I can't spell to save my soul, but I have been known to read 7 books in a week. I love my books, but e readers are easier to take on vacation! My mom was told I was retarded because I had such a hard time learning to read, I'm dyslexic, and old enough that there weren't programs to help. I was lucky, books were part of my family, so were always around. Don't really know why, but a lightbulb went off in my head, and I was reading everything I could get my hands on. However, reading out loud in class was beyond horrible!! even when I was reading at college level in the fourth grade. I guess what I'm saying is that judging, shaming, or blaming aren't helpful to people who struggle with this issue.
    anotherone and lemur00 like this.
  6. Visit  Overland1 profile page
    3
    Mabee prntd thngz shud b prntd like txt msgs so ppl wud undrstnd m.
    anotherone, jrwest, and bbuerke like this.
  7. Visit  Ntheboat2 profile page
    4
    Quote from Sugarcoma
    I learned quickly to stop using terms like hypertension, diabetes, and acid-reducer. Replaced with high blood pressure or high blood, sugar, and "this pill is for your belly so you don't get heartburn."
    A lot of people use the dumbed down version of medical terms (in the south anyway) even if they are well educated. I know that before I worked in the medical field even simple words like hypertension, hypotension, emesis, etc. were completely foreign to me. I had no need to know medical terminology. My grandparents used to call their lasix their "water pill" which is really what it is...I've heard people call diabetes meds "sugar pills."

    I know what you're saying in general in your post and I agree with you. I'm just saying...I use basic, "real life" words with patients whether they have a 5th grade education or a PhD because ...well...that's just the way I am and I don't think people have a clue what their nurses are talking about half the time. EKG? glucometer? hang some fluids? insert a foley? HUH?! My well educated non medical field experienced self would've been CLUELESS what was about to happen. Being illiterate must be terrifying.
    anotherone, bbuerke, Sugarcoma, and 1 other like this.
  8. Visit  Sugarcoma profile page
    1
    Quote from Ntheboat2
    A lot of people use the dumbed down version of medical terms (in the south anyway) even if they are well educated. I know that before I worked in the medical field even simple words like hypertension, hypotension, emesis, etc. were completely foreign to me. I had no need to know medical terminology. My grandparents used to call their lasix their "water pill" which is really what it is...I've heard people call diabetes meds "sugar pills."

    I know what you're saying in general in your post and I agree with you. I'm just saying...I use basic, "real life" words with patients whether they have a 5th grade education or a PhD because ...well...that's just the way I am and I don't think people have a clue what their nurses are talking about half the time. EKG? glucometer? hang some fluids? insert a foley? HUH?! My well educated non medical field experienced self would've been CLUELESS what was about to happen. Being illiterate must be terrifying.
    Ntheboat2 you make a great point!!! Even the most educated person doesn't necessarily understand medical jargon. I know for myself, we use those terms so often when talking with other nurses, docs, etc. it is easy to forget how foreign our world and language is to non medical people. I found myself using these terms out of familiarity and ease for myself I guess. It was only after seeing the puzzled looks on my patient's faces that I realized I needed to modify how I spoke to them. A great lesson and one that I am glad I learned early in my career.

    I am also from the south and my mother tells me all the time my dad's sugar is acting up or that he's all swole up and had to get some water pills lol.
    Ntheboat2 likes this.
  9. Visit  TheCommuter profile page
    2
    Quote from Sugarcoma
    It was only after seeing the puzzled looks on my patient's faces that I realized I needed to modify how I spoke to them.
    My father's been taking Lisinopril for several years. I asked him, "When did your doctor diagnose you with high blood pressure?"

    My father said, "I don't have high blood pressure. The doctor told me that my blood vessels are constricted from years of smoking cigarettes."

    The doctor could have straight-out told my father that he has high blood pressure instead of explaining it in a fancy, roundabout manner ("Your blood vessels are constricted").
    Sugarcoma and BrandonLPN like this.
  10. Visit  CrufflerJJ profile page
    0
    Quote from jrwest
    One word- De-evolution.
    Are we not men? We are DEVO!

    DEVO -- JOCKO HOMO - YouTube
  11. Visit  llg profile page
    2
    Quote from TheCommuter
    My father's been taking Lisinopril for several years. I asked him, "When did your doctor diagnose you with high blood pressure?"
    My father said, "I don't have high blood pressure. The doctor told me that my blood vessels are constricted from years of smoking cigarettes."
    The doctor could have straight-out told my father that he has high blood pressure instead of explaining it in a fancy, roundabout manner ("Your blood vessels are constricted").
    My late step-father would always say "No" when asked if he had diabetes. He would never include that on a health history form. But if asked directly, he would say, "No, I don't have diabetes. My doctor gave me a pill to take every morning to prevent that."
    brillohead and BrandonLPN like this.
  12. Visit  monkeybug profile page
    1
    Quote from Ntheboat2
    A lot of people use the dumbed down version of medical terms (in the south anyway) even if they are well educated. I know that before I worked in the medical field even simple words like hypertension, hypotension, emesis, etc. were completely foreign to me. I had no need to know medical terminology. My grandparents used to call their lasix their "water pill" which is really what it is...I've heard people call diabetes meds "sugar pills."

    I know what you're saying in general in your post and I agree with you. I'm just saying...I use basic, "real life" words with patients whether they have a 5th grade education or a PhD because ...well...that's just the way I am and I don't think people have a clue what their nurses are talking about half the time. EKG? glucometer? hang some fluids? insert a foley? HUH?! My well educated non medical field experienced self would've been CLUELESS what was about to happen. Being illiterate must be terrifying.
    I am Southern, and I remember the crazy looks I got while on travel assignment in California when I said someone was "just eat up" with poison ivy. Now, a doctor or nurse in the South would totally get that, but I had to back up and do some explaining on the West Coast!
    Last edit by TheCommuter on Dec 11, '12 : Reason: [/QUOTE] tags
    Sugarcoma likes this.


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