Another Brick in the Wall

Helping people who are trying to help themselves, at what point is the most basic patient education slipping through the cracks, and how do we stop it?

I'm a nurse who is somewhat new to home health. Almost every patient I visit either has hypertension, diabetes, or both. What troubles me about these people is that they have usually been in the hospital within the past 3 months for something to do with their diagnosis, but they know absolutely nothing about it. The education I'm providing these people with is basic blood pressure and/or blood sugar parameters, and what symptoms to look for, so that they know they should be checking their blood pressure/blood sugar and when to get help for it. The people I'm talking about are in every different walk of life you can think of, ages 18-108, some in housing projects and some in gated communities, and all they are trying to do is help themselves, or help their loved ones. I feel that we need to find a way to bridge the gap that I am so frequently running into.

I find myself becoming more and more frustrated, not with the patients, but with the doctors offices, the hospital system, with the medical community. Patients listen to me, wide eyed, looking at me like what I'm telling them is some new cutting edge science that was discovered in the past week. I have had someone tell me that she's not concerned that her blood sugar is 600+ because she, "usually runs 300 or 400, so it didn't seem like that big of a deal". One person with a history of stroke told me that they had no idea high blood pressure can lead to a stroke. There are so, so many people who cannot tell me what is viewed as a high or low blood pressure, or when their blood sugar is to high or low.

While I do understand these people should know these things already, and that they most likely have been educated in the past, it obviously didn't stick. It would be easy to point fingers, to say "oh well ______ should be doing this education, these people should leave their PCP/hospital/clinic/whatever knowing what they need to know and it's their fault.

Maybe we all assume that the other providers have properly educated this person, maybe we are skimming through facts to quickly, or maybe we just aren't listening closely enough to the people we are supposed to be advocating for.

We can go down the patient blaming road as well, maybe they were provided this information time and time again and just don't care or just aren't listening. There are some people who you can educate and educate over and over and they just don't get it, they don't take those first steps to help themselves for whatever reason. While I'm sure there is a percentage of people like that, this article is not referring to them. There is a huge difference between a diabetic drinking multiple sodas a day knowing that it will cause her blood sugar to go up and doing it anyways, and a patient who had no idea that her blood sugar was so high because she's drinking 3+ sodas a day.

I'm talking about people who are asking me questions, hungry for knowledge, just trying to understand what is going on with their bodies. They look at me confused, hurt, and sometimes angry (mostly with themselves), trying to figure out how they did not know this before. I had a conversation with a friend of a friend who is on Synthroid and told me they take it every day right after their breakfast, and they truly thought this was the way they were supposed to be taking their medication.

My questions to you are, are you running into this problem as well? Do you work in a facility with people who have stories similar to the ones above, or maybe this is just me? Please comment and tell me how to bridge this gap, what do you do to better your education with patients? What can I do to help and what teaching tools do you use to improve patient education? What practices with education should become mandatory that already aren't, and what is it that isn't working? How are so many people slipping through the cracks? Is there someone that can be contacted to help get at least the basic information out there for the public?

Again what I'm referring to isn't a long list of things that should be taught, I'm saying there are people I'm seeing who do not know even the most basic things about their own disease. So many people can be helped, and help themselves if they only have the right tools, the right information, the right parameters. Thank you for taking the time to read this.