Interprete Lab/Tests resutls to patients

ukstudent · Aug 1, 2008

Yes, you are not meant to be interpreting the results at all. That is the Md's job and you are not paid enough to put your license at the level of risk that misinterpreting the results, could leave you at. If pt's or family need to know the results have them talk to the doctor.

PS. needed to add that this is the reason that pt's are not allowed free access to their own charts, so that any results can be clarified with the Md.

racing-mom4, BSN, RN · Aug 1, 2008

I will and do give the family lab results if I know them and understand them. I have told family of trop levels, but 1st I explain what all can raise a trop level. I also will report of WBC is improving with tx. Or I will report that HGB are improving with blood.

Basically I only ever give good numbers--not bad.

If I dont understand it good or bad I tell them the lab faxes report to Drs office and when Dr rounds he will go over.

Logic being, I am not the one that is going to diagnose treatment if results are bad. But the way I look at it, if treatment is working, and family is worried and it is something they know they drew and are waiting the for results and the results are in and the news is positive, I will tell to put thier mind at ease.

jeepgirl, LPN, NP · Aug 1, 2008

YOU are not supposed to be interpreting results at all. That is what makes people unsure of their care... the nurse comes in and says this, the Provider comes in and says another.

If you are a provider you get additional training on interpretation. As a nurse you are not competent in doing this. So don't!! You're just asking for trouble.

pagandeva2000, LPN · Aug 1, 2008

I'd rather not do it. As mentioned earlier, I am not always familiar with all of the terminology, and also, the doctor may have a more concise explanation. I avoid doing it at all costs, whether it is good news or not.

Megsd, BSN, RN · Aug 1, 2008

Yeah the only time I will mention test results is if a test is normal or negative and I am 150% sure I understand what it means. If a head CT says "no acute injury" I feel comfortable saying that, but if it says "signal alteration noted with increased mass effect" I say... "I'd rather have the physician discuss those results with you."

I know patients and families get frustrated waiting for test results, especially when those are what are holding up a discharge, but I'd rather not misinterpret a test that could make a difference in their outcome.

ICRN2008, BSN, RN · Aug 2, 2008

Scope of practice is key in so many cases...just because you know something doesn't mean that you have the authority to tell it to the patient.

When I worked in peds, I only gave my parents their kids' numbers or a printout of that day's normal lab results as was our protocol. (These were parents of oncology or chronic kids who had already been taught what those numbers meant).

If any unusual labs were order other than CBC or chem panels and/or I was dealing with a parent who would have questions as to the meaning of the results, I would defer all conversations until the physician showed up.

When I was a medical technologist in the lab, same thing. I could report results but not interpret them. I once saw hairy cells (lymphocytes) on a smear. I was 100% sure of what I saw, but the only thing on my report was "abnormal lymphocytes". Off the record, I told the ER doc "I think I saw some hairy cells" but that this would have to be confirmed once the pathologist report came back.

It's one thing to report the results if normal or routine. It's another thing to interpret- that falls under the category of "medical diagnosis" which is out of the scope of practice of an RN.

mom and nurse · Aug 2, 2008

I didn't interpret the tests as an RN working in a hospital ... usually I referred the patient to the doctor.....

It's one of the reasons I went back to school. As an NP I can interpret the labs for my patients....

Babs0512 · Aug 2, 2008

I play it by ear, if the patient has talked to the physician, and I am simply clarifying what the physician said, in plan talk, then I have not problem doing that.

I've also given some results without the doctor's knowledge ie : " your pregnancy test came back negative, so now you must speak with your doctor to find out what else could be causing the discomfort"

If I didn't now what the result meant, I would most definitely NOT try to interpret it to the patient. You can always fall back on "That result hasn't come back yet, the physician will be in to discuss it with you as soon as he gets the result."

Good luck

ilstu99 · Aug 2, 2008

I don't interpret results. It's a big no-no for us. If a family has a question that's out of my scope, I advise them to keep a little list of questions and sometimes give them the piece of paper and pencil. Our providers are very good at coming to the bedside to speak to families, though, so they don't go without knowing for long.

I do give values for parents that request them, and if they have a question about changes (be they +/-) I again recommend that they write them down and refer them to the MD/NNP.

kmoonshine, RN · Aug 2, 2008

When it comes to xray or ct reports, even if the test is back I'll tell the patient that "we're having the radiologist read your tests right now, and as soon as we get the final report the doctor will let you know".

If it's regarding labs: if someone is on coumadin and if they're interested in knowing their PT/INR, then I'll let them know what it is if its normal (anything that is way off, I leave up to the doc). If I'm reassuring the family, I'll rattle off some of the normal labs until the doc can come by ("what's great is her potassium is normal, which is important since her water pill can cause low potassium"; "you're white blood cell count is normal, meaning that there isn't any evidence of infection in the blood").

I work side-by-side with ED docs, and often they are busy and are more than glad to have me update their patient regarding the plan of care. Sometimes there's things I need to do for a patient, and its only fair to let them know what I'm doing and why (ie low Hgb, GI bleed - and the patient is wondering "why are you drawing more blood, and why do I need two IV's"). I can't wait around in the ED for docs to give results to their patients, and delay providing them with critical nursing care. But I don't overstep my boundaries and I give what is necessary under the necessary circumstances. And I also make sure that I'm aware of the diagnosis prior to discussing any labs with patients (and I also make sure that the doc is on the same page as I am regarding plan of care and diagnosis).

november17, ASN, RN · Aug 2, 2008

Hey everybody,
what do you say when a pt or their family wants you to interprete a lab results/tests and you dont know how to interpret the result? anybody been in that situation.
.

I actually have a "canned" response for this situation because it happens quite often.

If a patient asks and is insistent, I say to the patient, "I'd love to tell you what it says, but I don't really know how to read them. If I could, I'd be getting paid a heck of a lot more money!"

The truth is I often do understand what the tests mean, and I've got a pretty good handle on most of the diagnostics at this point in my career. MRIs, CTs, XRays...I'm not one to give a patient bad news though, I leave that for the doc to handle.

When the test results look good to me, I will tack onto the above statement, "But, for what it's worth, AND I'M NOT A DOCTOR SO I DONT REALLY KNOW WHAT IM TALKING ABOUT HERE, IM JUST GOING FROM EXPERIENCE. I'd say you're going to be okay!" I really emphasize the "I'm not a doc" part. That usually relieves some stress from my patients or their families to know that they're not in for terrible news...and again I only say that if the results look really good/normal. I think people really appreciate that because you're being real with them and not blowing them off like every other hospital worker does.

Sometimes I even show the patients their xray, just to illustrate how much they screwed themselves up. We handle a lot of broken bones where I work, and it really seems to come home and they understand when I can show them exactly what the heck is going on internally. I know I would appreciate the same treatment if I was a patient. Rarely can doctors be bothered to do that kind of stuff.