As a nurse, one of the main focuses of our job is to educate
our patients. We are responsible for teaching them about any procedures that
they may be having, about any medications that we are giving, and side effects
or symptoms from their diagnosis, and how to take care of themselves properly
when they are finally in their own care.
In
nursing school, we are taught to assess. Assess everything. Always assess
first. The word assess is drilled into our thought process so that we assess
before taking any actions. The same type of assessment is used with patients
that may have inadequate health literacy about the information that we are
giving them. So, in the situation of teaching patients, we must assess first.
We must assess how they may learn or attain information. Do they prefer hearing
you give instructions, writing down instructions, drawing pictures to describe
the instructions, reciting back the instructions to us? We, as nurses, need to
find out the best mode of how to teach our patients. Is the patient going to
have a spouse, a child, or another caregiver help them at home? If so, it is also
wise to invite them to the learning session. Then, if they have questions at
home, another ears heard what you said. But of course, always give them a phone
number to call the healthcare facility if other questions arise later. According
to Health.Gov, “Approximately one in sex Americans has a communications
disorder or difference resulting in unique challenges. These individuals will
require communication strategies that are tailored to their needs”. This means
that when we are specifically talking to the elderly population who may not be
educated in the area of medicine, we also need to account for any communicated
disability that they may have. Again, we must assess.
Although
it is easy to assume that the elderly may have low health literacy, we have to
assess each patient as an individual. Some elderly patients may know a lot
about the medical field and some may know nothing. As an evolving world,
technology is also becoming more and more prevalent. With the elderly
population, they may have no use for a website address to go to or an app to
download to help manage their health. According to The American Nurses
Association, “the content of Internet
information and the structure of this information are two additional obstacles
for Internet users with low health literacy. Health information websites are
notorious for using overly complex and scientific language that makes the content
difficult to understand and use.” We have
to continue to assess what resources are appropriate for the particular patient
and proceed from there.
After
we assess the best way to educate our patients, may that be listening, seeing,
or repeating back the instructions, need to use words in a way that makes
sense. If we go around using medical jargon such as “hyperglycemia” or “diabetic
ketoacidosis”, such as in AJ’s situation, they might not know what we mean. If
we use words like “high blood sugar” or “symptoms caused by excessive and
prolonged high blood pressure” the patients may be able to better understand
our education.
After
the information was given to the patient, the best way to make sure that the
patient understood what was said would be to ask the patient to repeat back to
the nurse what they just learned. This way, if they are unable to repeat the
new information, the nurse can reteach it or else try another way of explaining
things so that the patient can understand.
In AJ’s
situation, what would have been helpful for not only AJ, but for the nurse,
would have been to include short teaching sessions throughout the hospital stay
about his diagnosis and home health regimen. The nurse could also have given
him written instructions about when to perform the blood glucose monitoring, how
to read and interpret those results, and how the insulin should be
administered. Explaining the reason behind the procedures is also important so
that the patient knows why this should be important to them and that there are
real risks if they are not done. Once all of the information was given to AJ,
it would have been beneficial to ask AJ simple questions about how to take him
blood sugar and even have him demonstrate it. If the nurse sees that he is able
to do it himself a few times and interpret those results and how to go about
self-administering insulin, the nurse now knows that the teaching was effective
and that AJ comprehended and understood the education.
Egbert, N., & Nanna, K. (n.d.).
Health Literacy: Challenges and Strategies. Retrieved September 21, 2015, from
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No3Sept09/Health-Literacy-Challenges.html
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