As an emergency room nurse, there are several times per day when I am presented with an opportunity to provide patient education. From dispelling common myths in triage to providing discharge instructions, it is one of our most important roles as nurses to provide solid education to the patients and families we meet every day.
Whether it’s the importance of hand hygiene, or how to properly take antibiotics, or the home management of diabetes, every piece of information we can impart to a patient can make a real difference in the wellness and health maintenance of our patient population and their families. Providing patient education is just as important as the other nursing care we deliver.
In a perfect world, nurses would have unlimited time to sit with patients and make sure they’re hearing what we are saying. We would have time to assess their preferred learning methods and to help them understand. We would have time to do a 15-minute crutches demonstration, for example, or to go over every possible side effect. And some days, we can! But how can you make sure you’re not skimping on patient education when staffing is tough, you’re stretched too thin, and when patient education might otherwise fall by the wayside?
Write it out. Sometimes I don’t have the time I would like to fully explain a patient’s home care instructions, but boy am I a fast typer (thanks, electronic medical records!). It takes me only a few moments to quickly type out home care instructions. Then, anything I want them to remember I know they are at least taking home with them. This is essential, since they won’t necessarily remember exactly what I said, but can refer back later to what I wrote.
Print! Find a patient education material app or website that you like or that your facility participates with. For me, it’s Mosby or Up-to-Date, which has pages and pages of patient information and handouts designed specifically for printing and passing over to the patient. Most are written at an easy reading level and include illustrations, and many are printable in other languages, as well.
Highlight! Stick a highlighter in one of your (overflowing) scrub pockets. If you’re pressed for time, highlight the most important pieces of the discharge paperwork for easy review. There is a lot of great information in a discharge packet, but there’s also a lot of extras. Make sure to give a brief guided tour of the paperwork and point out relevant lab results, follow up instructions, and home care.
Use teach back. One of the best ways to ensure patient learning is to ask them to teach it back to you, or at least repeat it back. You would be surprised how many times you have just gone over something only to have the patient forget what you just said or have missed your point entirely! It’s worth taking a moment to say, “Now tell me, what signs and symptoms would prompt you to seek help?”
Keep it brief. Remember, most people can only remember one or two learning points. Try to pick the most important ones to emphasize with the patient, and leave the rest for the (highlighted!) paperwork.
Include family members. If an elderly person seems particularly adverse to learning about fall prevention, enlist any family members to help. Especially in the case of family caregivers, who play a crucial role in patient’s well-being at home, it’s important to involve them in the learning process.
Don’t assume that your patients already know what you’re going to say. Don’t assume that the diabetic or hypertensive patient knows to take their medications even when they’re ill. Don’t assume that parents know to give their children the appropriate dosages of medications based on the child’s weight. Don’t assume that someone with a GI bug knows to eat a BRAT diet when resuming foods and fluid intake. Say it anyway!
Allow enough time for questions. Give the patient ample time to ask any questions about follow up care, medication side effects, or any disease process or health maintenance after discharge. Make sure he or she knows who to follow up with, too. I usually phrase this as “Ask me anything right now, and direct all questions after you leave to Dr. Smith or your primary care physician.”
Don’t leave it all for discharge! Remember to provide bits of information and patient education throughout your care for a patient and not just at the end of his or her visit. This prevents overwhelming the patient with details as they are about to leave, and helps make sure more of what you say can be retained.
It is our responsibility to ensure health literacy and competency in our patients, and that can start with little bits of information and education that we can pass along all throughout our care.