Lab and diagnostic test results?

AuntieRN · Jan 22, 2008

This confuses me too. We were taught in school not to give this information but refer them to their physician but then some nurses tell me we can we just cant tell them what they mean. I hope someone can answer this for us clearly.

MelBel · Jan 22, 2008

I usually don't give any information to the patients...I either tell them the results aren't back, or that the doctor is the one who has to discuss the results with them. Occasionally there are exceptions, such as...

1) If I have a patient taking coumadin, who wants to know their INR...they are educated and it is relevant.

2)Or if a patient is to receive a blood transfusion, and they are curious, I will tell them their Hgb and how it compares to a normal level.

oneproudigorot, MSN, RN · Jan 22, 2008

i think it would be better to tell them to consult their physician about the result...

RNcDreams · Jan 22, 2008

I work in ER, and test results are often why the patient is still in the department... i generally say something like "There is nothing critical on your test results, but the doctor is the person who can further answer your questions and clarify what the results mean."

Since the doctor may be tied up in a code or seeing 7 other patients, it could be awhile. A generalized answer can sometimes alleviate a lot of anxiety.

If the person starts to ask questions I am not comfortable answering (i.e., the "interpretation" portion) I will simply respond "That question needs to be asked of a doctor. It is out of my scope to interpret results."

Most patients will accept your limitations.

I will let them know that they have an infection of some sort (if they presented with c/o infectious symptoms, & I see they have an elevated WBC count), they have a UTI (if they present with dysuria and foul smelling urine & have nitrites, bacteria, and leukocytes in their ua/cs), etc. But, I provide these answers ONLY in situations where the answer is very, very clear.

Otherwise, I smile and say "The doctor will be with you as soon as he can!"

Indy, LPN, LVN · Jan 22, 2008

I like to alleviate anxiety when possible, but I always explain that it's a scope of practice issue; the doctor will have to interpret the results so I really shouldn't be giving them if I can't interpret them specifically for that patient.

So. Middle-aged lady whose troponin is over 40, but has stabilized a bit and can breathe, is on cardiac drips, has atypical or no chest pain, and normally denies what symptoms she does have, is anxious about her lab results. Hm. Add that it's 3 am and she finally is clearheaded enough to be worried, she slept all day and no doc is coming through in the next 4 hours to explain things to her. I want her to rest; she wants to know something so she can rest. She says, "the doc mentioned my number on my enzymes was high, did I have a heart attack?" I explain scope of practice and then a bit about my background. "From my experience, what the doc meant was that your heart is definitely having a problem, but he's going to have to explain to you how severe it is." That gets me around the interpretation business, the lady is not completely stupid, just needs a little info and will gladly wait on the interpretation. We then move on to plan of care issues like, I want to know symptoms, and she will rest and relax, if she needs help with that, I've got what she needs.

It's not always that scripted but it's really painless to explain things to people if you mention scope of practice. It certainly keeps you from putting your foot in your mouth and having to deal with it later.