The reality of educating patients about their meds

[DolceVita, ADN, BSN, RN]

To all of you out there in practice...

In school they are always going on about patient education. I agree about its importance but in reality do you really get to do this?

For example, lets say you work in an outpatient clinic, every outpatient appointment I have ever had ends with the doctor leaving the room. No nurse comes in an explains my new medication to me (they or a tech review my medications at the beginning of the appointment).

In what settings do you actually get to do this with patients/clients?

[Tait, MSN, RN]

As someone passionate about patient education I take every opportunity to teach my patients about their meds, why they take them, how to take them, and when to question their physician about them.

I use drugs.com all the time time for printouts.

However! I will cite that I work bedside on a med/surg floor so I have some time. As far as clinic instruction, I am not sure how often there is much instruction...but I am working on that

My mother and I a few months ago (my brainstorming, her proposal writing skills) started putting together a clinic patient education concept blending kiosk style print stations and full-time education clinicians. We were just doing to for fun, however I found out this week after my mother attended a public health board meeting (she is in community health programming) that there are similar ideas percolating among many facilities in Wisconsin to integrate more in-depth education into clinic visits!

Keep your eyes open! There may be new adventures just over the horizon as patient education steam rolls through facilities across the country.

Tait

[annaedRN, RN]

I work in home health...and while I provide the same basic bedside care that is done on a med-surg floor (IV, wounds, catheters, blood work....) the setting is VERY different. The whole set up of one on one is designed to assess, provide and most importantly TEACH! At the hospital/facility, it is a controlled environment and due to demands on the nurse, the time to teach is not always there. More importantly, at home, the patient's comfort level is increased..usually meaning the teaching seems to be more readily absorbed..as well as adjusted to the patient's environment..not the hospitals. I like to think of hospital nursing as acute nursing and home health as real world nursing...just my opinion. Home health is definitely my niche

[SweetLemon]

I try really hard to do some sort of patient education each time I pass out meds. TRY being the operative word... sometimes patients are just not in place they are wanting to be educated and I can't force it only highly encourage it. I have on more then one occasion had a patient tell me "I don't care can you just give me my meds" but I keep trying hoping eventually they will take a higher interest in their care.

I also find the more I educate others about medication administration the more I learn, they ask questions and this prompts me to seek out answers.

[SaraO'Hara]

I do try to at least say "This is your x, for your condition y" during med passes. On discharges - I encounter a disturbing number of patients who seem to have the attitude that it's the duty of the staff or doctors to know what they take, not their personal responsibility. I don't usually have time to teach / work on reversing that attitude.

[RNperdiem, RN]

A lot of postoperative patients get a PCA for pain control.

Unless they have extensive hospital experience, they will require some education about the use of the PCA, techniques for maintaining pain control and instructions for the family about the patient being the only one to use the pain button to prevent overdose.

Patients often have fears and misconceptions about narcotics and require some education.

[leslie :-D]

oh my gosh, i educate all the time.

whenever i administer meds for the first time, i tell them what it is, what it's for, common side effects and when to call for a nurse.

big reality where i work.:)

leslie

[MadisonsMomRN, BSN, RN]

oh my gosh, i educate all the time.

whenever i administer meds for the first time, i tell them what it is, what it's for, common side effects and when to call for a nurse.

big reality where i work.:)

leslie

Me too! I am always teaching...

[SteffersRN87, BSN, RN]

I work outpatient oncology and invasive procedure recovery. I do take the time to do patient education, but not as extensively as in nursing school. For all of our invasive procedure patients (heart caths, angio, GI procedures, etc.), I give them the handout provided by our unit with information about their procedure. I give a quick overview of what's on it and answer any questions. If they have a new med, I print up the patient version of the drug info from Up To Date. I review important details and send them home with it. If it is someone who is extremely HOH or legally blind or anything like that, I make sure to include the family as well. I have 4 to 6 patients a day that I prepare and recover, so I do a lot of teaching. But I feel that it is my personal obligation.

[PostOpPrincess, BSN, RN]

It's very, very important that someone understand the drugs and their side effects. I work in outpatient surgeries sometimes so it is imperative that they get the information--especially the families.

We use Micromedex a lot.

[nerdtonurse?, BSN, RN]

We were told that we couldn't print off info, even from the drug manufacturer's website, because our medical staff hasn't approved it... so even if you're getting tygacil, I can't give you the printout from tygacil.com ....

But I teach all the time. One of the big things is dark green leafy veggies vs. coumadin. I keep telling the pts, "If you eat a dark green leafy veggie 3 x week, that's fine. If you never eat them it's fine. If you eat them 3x a day, it's fine. The secret is, don't change your pattern; the blood work is based off what you're currently consuming. It's not that you can't eat them, it's that you have to be consistent." And BTW, one of the worst things for messing up your INR when on coumadin is ....blueberries. Not green. Go figure.

[SouthernComfort31]

I do try to at least say "This is your x for your condition y" during med passes. On discharges - I encounter a disturbing number of patients who seem to have the attitude that it's the duty of the staff or doctors to know what they take, not their personal responsibility. I don't usually have time to teach / work on reversing that attitude. [/quote']

I am all for patients taking responsibility for their medication regimen. But at discharge, clinicians are supposed to know what patients take; they are supposed to know what patients will be discharged home with. It's called med reconciliation (happens at admit, transfer, and discharge). It's a national patient safety/JCAHO goal. And if clinicians feel they can't meet this requirement, then what is intrinsically wrong with the system that leaves them ill-informed about what meds their patients are discharged with? Any thoughts? I'm sure the usual answers will pop up: lack of time, lack of adequate staffing....are places utilizing discharge coordinators? Discharge nurses? I wonder what's out there....