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?
For some of the chronic conditions it has been shown that the more that you educate costs are reduced by "bounce-back" admits. It is a nursing/medicine's responsiblity to educate, but it the patient's responsiblity to be receptive and act on the teaching. Sometimes it isn't about the what (the drug or lifestyle change, etc) does but rather it is the WHY they have to make the change is what patients need to really understand.
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?
Of course we teach. That is part of nursing, and a very important part of our job as well.
I teach patients about their meds and not just the first time I give them either. Every
single time I adminster meds to a patient, I tell them what it is I'm opening, what it's for,
the dosage and are they familiar with this med. I had one patient ask me one time, "why
are you telling me what meds I take?" I educated the patient that it is very
important to be proactive in their health care, and very important to know what medication
is being administered to them and what it's for. That kind of tripped me
out to be asked that......my goodness, I want to know what I'm swallowing,
don't you?
There are so many patients that tell me......"I didn't understand what the doctor said when
he came in because he talked so fast." Once again, another opportunity for education.
I explain to them that this is their health, keep the doctor in there and ask questions, write
questions down before they come in if needed. Always always always know what is going
on with their health.
Another example of teach, every single time I adminster insulin, I make sure they know
the s/s of hypoglycemia and that they need to call me if they feel such symptoms.
I teach patients that have been bed ridden to turnq2h, if they can by themselves,
if they can't, I teach them why I'm doing it. I teach them the importance of
washing their hands and that visitors do the same. More examples to teach on:
Isolation precautions, why we have to monitor INR for liver failure, why we administer
FFP, why we administer blood. There is so much!!!!
There is a lot of teaching. I can't get into it all here, but there is usually always
something I teach every time I walk into a patients room. And if there isn't any
teaching going on, the nurse must not be doing his/her job.
Patient education is an issue I became very passionate about this semester. While there may not always be the time to sit down and educate, there is always time along the way. To me, educating the patient is giving them the why's of what we are doing. I know you were speaking about meds, but some posters have pointed out ways of educating while administering medications. I especially like the idea of teaching s/s of hypoglycemia while giving insulin injections! That's not one I have thought about before.
I notice that once I educate my patients (even if it is in the slightest), they seem much more cooperative. I had a CVA patient who didn't like his SCDs. Once I taught him why they were on, (Mr. Jones, we are using this to help prevent another blood clot like the one that caused your stroke!).... He was more than happy to put them on.
Since you are speaking of meds, if anything, stress the importance of reading the information packet that comes with the medicines you're patients will be taking. And stress it again before they leave. Maybe you may not have all the time in the world to educate, but that one piece of information could be the difference! You'd be surprised how many people don't even realize there meds come with an information packet!!!!
I work outpatient psych, and I help quite a few patients with their weekly med boxes, and each week, we go over each med they take, including what it is, why they're taking it, any side effects. I also run the weekly injection clinic, where I administer long-acting antipsychotics, and each week, for each patient, I go over what I'm giving, why the patient is taking it, and we discuss whether the patient thinks it is working, and whether s/he is having any side effects.
I use a LOT of printed material from drugs.com and Epocrates.
If I get a patient that is psychotic or delusional, I might hold off on more in-depth education until the patient can understand and tolerate the amount of information, but at the very least I always tell them 'This is med X which will help with symptom x,y,z'. I also give that person the most common side effects to watch out for.
I work LTC and do a good bit of education. Since our LTC doesn't = a warehouse for old people, alot of our residents are having shorter stays and going home faster. Not a lot of time for education, but it gets squeezed in at every chance. I always let them know what this pill is for, ask about diabetes (is this new for you since being in the hospital?) and always try to include the families if they are present and active in care. A big one now is infections..esp CDIFF and what to monitor when you go home etc.
In cardiac, we start people on beta blockers, ace inhibitors, anticoagulants, and lipid lowering drugs all the time. I do educate my patients on these medications when I know they are new for the patient. I explain in layman's terms why they are getting these meds and the most common side effects. At discharge, we have a cardiac educator that does more in depth teaching, but when the cardiac educator is not on duty later in the day, it's up to the nurses. I print out literature from our hospital's electronic library and go over the highlights with the patient.
In the ER patients will drive you nuts with their drugs. Many, many, many are on a little white pill, nope, don't know what dose, nope, don't know why "the doctor told me to take it. Why can't you call him, he knows all my medicines?" Usually no interest in finding out why they're taking it either.
Today I triaged a man with chest pain, sent from the office to RO MI. So he tells me his meds and he's on Crestor, Atenolol, and something for sleep. Nope, never had heart troubles, nope, lungs are fine too. Nope, never had this chest discomfort before. Well he had some dizziness last week with his chest pain...no, nurse, that was chest pain, and this is just a little discomfort. What did he do to make it better, well he took his nitro pump, of course. Yeah he uses that all the time, but didn't use any today, cause this is discomfort, not like the pain he usually has. No- he doesn't have heart problems-well...yes, he had a heart attack 3 years ago, but no problems since then. Arghhhh.
I was spinning by the time they went out back. And that was just ONE of my triages today. God only knows what comorbidities I miss because the patient doesn't think they are problems any more. Many many are caught because the patient is on a medication, but those aren't problems, per se, the med FIXES them!!
in the pulminology clinic that I am a patient in the nurses are VERY involved in the teaching.
My first visit the nurse came in after the doc left. Showed me how to use my spacer, told me when to use my meds and also made a point that, had she not pointed it out, i would not have thought of however after she said it it seams obvious. (if i were to need fast acting med and it was time for controler med use fast acting first and wait 10 mins before taking controler.
I had not seen THAT nurse for a while till my last visit when she tracked me down to see how i was doing. However I have spoken with a few others on the phone when I was having issues, one taught me about using albuteral and atrovent at once and how often I can use my neb against orders but safely. so in that clinic the nurses are VERY involved in teaching.
moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS
521 Posts
For some of the chronic conditions it has been shown that the more that you educate costs are reduced by "bounce-back" admits. It is a nursing/medicine's responsiblity to educate, but it the patient's responsiblity to be receptive and act on the teaching. Sometimes it isn't about the what (the drug or lifestyle change, etc) does but rather it is the WHY they have to make the change is what patients need to really understand.