There is a new emphasis on better discharge planning, patient self-management of chronic disease, and patient engagement. Patient education is critical to all of these initiatives, and nurses need to know what works and what doesn’t, when it comes to shaping patient behavior.
Like most nursing competencies, patient education is a skill that develops over time – it takes practice and commitment. In today’s healthcare environment, nurses need to get in the habit of providing patient education as part of routine care, because it improves the likelihood of good outcomes.
A recent NPR story gave an account of a hospital in Georgia that hired nurses especially for the role of patient educators, calling them care managers. These nurses spent time with recently discharged patients who had poorly controlled chronic conditions, working with them one-on-one until they became more adept at the skills they needed to manage their own health, like calculating an insulin dose. One of the biggest take-away messages from this story is that patient education should not be considered a one-time event – it works best when it is part of an ongoing interaction and occurs during a conversational dialogue. Too often, patients are expected to absorb and retain a huge amount of complicated information after a short period of instruction.
Take an individualized approach
Probably the most common mistake nurses make with patient education is teaching based on the patient’s medical condition rather than on individualized needs and learning ability. An individualized approach is by far the most effective method, and begins with an assessment of the patient’s needs and capacity to learn. When patients are in pain, medicated, or experiencing emotional distress, their ability to concentrate and take in new information is hindered. It’s important to assess the patient’s physical, psychological, and cognitive readiness to engage in learning. You’ll need to determine how much the patient already knows, and how much of a gap there is between his or her existing knowledge and what he or she needs to know to manage his or her own care effectively. It also may help to ask the patient about his or her personal goals for treatment, in order to find out what motivates him or her.
You may know from your own experiences in nursing school that different people have different learning styles – and you can apply this insight to your patients as well, starting with an understanding of their ability to read and comprehend materials written in English. Would printed materials in another language be more helpful? What about checklists, diagrams, video, live demonstrations, or learning through hands-on practice?
Use the teach-back method
When you give discharge instructions or teach a patient how to dress a wound, it’s easy to fall into the trap of asking “do you understand?” and being satisfied with a nod in response. Yet this is not an effective way to gauge a patient’s comprehension of knowledge or mastery of self-management skills. Instead, studies validate and experts recommend using the teach-back method.
The teach-back method involves two-way dialogue, which allows you to more easily reinforce health information. When you finish teaching, you ask the patient to explain it back to you, in his own words. Likewise, when you finish demonstrating a procedure, you ask the patient to demonstrate it on his own. In this way, you can determine where the gaps in the patient’s knowledge exist, and work to connect the dots.
Advance your career
If you discover you have an aptitude and passion for patient education, you may be able to seek out jobs that allow you to put this skill to good use. Home health nurses often engage in patient education at a higher level than do traditional bedside nurses, teaching patients how to care for a PICC line or ostomy pouch, for example. Hospitals are currently adding positions that put nurses in charge of post-discharge care and instruction. You may also find work within a private physician practice as a diabetes educator or pre-natal educator. Even pharmaceutical companies and insurance companies hire nurses to act as patient educators.
The first step toward fine-tuning your career may be to empower yourself with knowledge. American Sentinel University is an innovative, accredited provider of online nursing degrees, including an RN-to BSN program and advanced degree programs that prepare nurses for a specialty in case management, infection control, or executive leadership.