Education of patients - Who can do it?

Dolce, RN · Jan 30, 2008

Wow. That's ridiculous. One of the most needed roles for professional nurses is patient education. I cannot imagine eliminating from my nursing care. Every place that I have worked for has included this as part of the nursing assessment and admission. Of course we cannot teach a patient about the diagnose patients (that's the doc's role) but we can educate them about their diagnoses. When patients question me about the meanings of their lab work as it relates to a possible diagnosis I always refer them to their doc because I don't want them to say, "The nurse told me I have heart failure." But, if they already have the diagnosis I will help explain the diagnosis to them.

rnmi2004 · Jan 30, 2008

Are you sure you are understanding this situation correctly? Patient education is a major part of nursing care.

Sometimes patients have questions for me about specifics of their surgery or what their test results are before the MD has reviewed it with them. In those instances, I will give them a paper & pen, and encourage them to write their questions down, as the physician is the one who should be answering these questions. The MD is also the one who should be explaining procedures, possible complications, etc. to the patient (informed consent).

I have no problem educating the patient on the disease process if it is a diagnosis I am familiar enough with to provide accurate information. For instance, my floor has a lot of patients with bowel disorders, so I would be comfortable discussing diverticulitis with a patient.

I'm pretty sure the Joint Commission takes a look at patient education when they audit facilities. Having a policy in place where nurses are not allowed to educate patients would be a big red flag to them.

nyapa, RN · Jan 30, 2008

Thats crazy! How far do they say we shouldn't educate?

*Medications - aren't we allowed to say what they are for, how and when to take them, what side effects to look out for?

*Diabetes - arent we allowed to say what is an appropriate diet, why they can't eat chocolate, to look out for deterioration of eyesight, tingling in their feet, looking after feet especially if there are wounds etc etc?

*Deep breathing and coughing exercises post theatre?

The list is endless?

Do we just go in and tell them what do to, without explaining why? 'I'm going to give you this injection?' 'What does it do?' 'Oh you'll have to ask your doctor or the pharmacist'

That would really engender trust in a patient!

bosnanurse · Jan 30, 2008

I did ask all this myself . A student who asked me and told me about this problem was in my clinical group last semester and she is a very sharp ex teacher herself.So , she did not jump into saying ooo you have a diverticulitis but it was an admission diagnosis, pt had a surgery r/t this problem and she explained him again about food, process ,pockets and all that. I asked if she look for the answer and explanation from other nurses not only particular one who told her this. She said that "a charge nurse" said it is not OK to say anything except to give written material or to help him write the list of the questions?? Hmm sometimes I would like to ask but I do not even know what I do not know!!!! So , I was "digging" whole night through the ANA site, NY state nursing site, asked my supervisor, asked my peers on the floor and we really do not know what is the problem here. It is not MY hospital THANK you LORD, because I would leave it no looking back:behindpc: . It is the hospital in the same town as mine, so I did not want to ask too much in my hospital for opinion just to not look as I have something against the "Magnets girls". I do not , but I have against not teaching pt AFTER they had MI , after they had BYPASS, after they survived CPR . Even doctors ask me sometimes if I gave the patient all information about discharge teaching and follow up.Nobody really likes to say "Hmm your labs are blblbbl so your hart is dying.." I will leave this to doctor. But to teach him how to conserve energy, how to eat, why he is SOB yes, I will do it. It is just a nonsense to think otherwise. Who wants to take my job from me , that is a question??!! :nurse: :bbykck:

mianders, RN · Jan 30, 2008

Even JCAHO requires documentation by nurses, OT, PT, ect.. on patient education. It may be this hospitals policy but it is not the standard. I work in Oncolgy and patient teaching about what the patient should expect is a necessary part of my job. Our hospital has information sheets on disease process and medications and I go over these with my patients. You are not diagnosing the patient. It is just reinforcing the information they should be receiving from their physician. If you want more information about where education falls in your scope of practice contact your states BON.

jessiern, BSN, RN · Jan 30, 2008

We are strongly encouraged to provide patient education when patients are admitted. We have to provide pamplets, and the patient gets one copy to keep and they sign a copy to remain on the chart to show they were provided with education. Most patients have no interest in receiving the info, and just want to sign the paper and be left alone. Guess you can't force it on them....

classicdame, MSN, EdD · Jan 30, 2008

In Texas the Nurse Practice Act states that only the RN can determine the plan of care and the education that goes with it. Of course, the MD must explain procedures, but most MD's here will write orders for RN's to teach about the disease process. I hope you misunderstood the policy!! Otherwise, nurses will return to the handmaiden status.

bosnanurse · Jan 31, 2008

I hope you misunderstood the policy!! Otherwise, nurses will return to the handmaiden status.

I felt the same. I hope it is some "charge nurse " response or it is reactionary response to some problem that was in this hospital so they are going now NONO nobody will do anything except docs. Well , I will follow this to see from other resources also . It is a big deal for the nursing students also. It looks like school teaches them something wrong and we do not!!!

Thanks. :twocents:

Altra, BSN, RN · Jan 31, 2008

The only thing I can think of is that this particular hospital, in the infinite wisdom of its management, has decided to "script" patient education so that it is standardized. Thus, the pre-printed handouts and the discouragement of individualized verbal instruction.

I'd make sure that this is indeed the policy, and that the policy is being interpreted correctly. Then, I'd walk.