Exploring Nurse Patient Education
As a team of nurse-patient educators in a secondary hospital, we realized how important it is to inform the patients regarding their health problems especially those who need lifelong therapy. (Photo: ICUnurses / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) via Wikimedia Commons)
Imliyangla
M Sc (Nursing), In-Charge, Patient Health Educatio
Medicine Department, CIHSR
When people get sick, they visit the doctor and after a series of questions and tests, get the diagnosis done. They are given medicines and sent home. In all the hospitals, similar story prevails. The patients get admitted and undergo almost the same process and once they improved, they go home and are called for follow up a few days later. During all this process, the patients and relatives have bazillion (a large number) questions in their mind. They go with fears and anxiety searching for answers to their problems. We live in an era of information explosion and this can sometimes add to the anxiety as many turn to ‘Google’ for their queries. The healthcare provider may not have enough time to discuss all the questions during the brief 10 to 15 minutes’ encounter with the patients. So the need of the whole team coming together, be it doctor, nurse, pharmacist, dietician, physiotherapist, laboratory technician, etc. discussing the overall care in the path to treatment becomes important. Every health care personnel can put their input, creating awareness among the patients. A well-informed patient is better equipped to take proactive steps in taking better care of their health. Not just following the instructions, but when they know what and why things are being done on them or for them, they are better involved in the whole treatment and they can make a better-informed decision in their care.
As a team of nurse-patient educators in a secondary hospital, we realized how important it is to inform the patients regarding their health problems especially those who need lifelong therapy. Many of the patients are not able to read and write English, or even if they can, a majority are health illiterate i.e., unable to understand health care information and what they need to do with that information. Giving them brochures, booklets, pamphlets are not adequate as many of them may not understand why they were hospitalized or why they need to follow up even if they feel they are alright. Added to this, we tribals have lots of myths, beliefs, and the kobiras (local quacks) still play a very important part in our health-seeking behavior. There are instances where we encounter some patients with chronic illness discontinuing their medications which were needed for lifelong because some prayer centres advised them to rely on prayers alone. This is saddening. Faith and treatment should go together. Breaking the myths which have been passed down through many generations is not an easy task. Without proper health education, the patients will return home and resume the previous lifestyle until they have another episode of the same health problem. One of the most common issues we face among our people is lack of adherence to treatment resulting in complications and getting admitted because of stroke, kidney failure, etc. Some of these problems can be prevented or even delayed to some extent if timely proper care is taken. These phrases seem so common to many of us, but only a few take it to heart and follow. So there is a huge need to make everyone aware of this so that they adhere to the treatment regime. Assessing the challenges, the patients face in following the health advice will go a long way in addressing these issues.
In the journey as nurse-patient educators, our patient experiences have been enriching us in many ways. When patients share what they know about their health issues, their expectations, and beliefs, we also learned about our society as a whole. At times, through their doubts and questions put forward to us, we get to know how much we still need to learn to help them better. There is a lot that needs to be done in this part of patient care so that the patients are empowered to take better care of themselves. Sharing some of our experiences in this area, Tsungdenla, Nurse patient educator said ‘Patients come to the hospital with many doubts. And as their doubts are being cleared during the health education, their anxiety level comes down and are satisfied’
Another nurse working in the same unit, Linda added ‘My experience as a patient educator in CIHSR for the last five years has been a challenging journey but yet it gave me a great sense of joy and satisfaction. The journey began by giving diabetic education and later on other health conditions were also added as the need arise. Interacting with patients has helped me learn so much about our people’s attitude towards ‘health and sickness’. I realized that our people were fed with myths and taboos that led to wrong practices. The best part of being a patient educator is when one patient brings another ten more patients for education during the next visits’. Creating a snowballing effect in our community by our patients brings us immense pleasure in our work. And this also gives us a huge responsibility to provide correct information and remain abreast of the growing technology in the field of healthcare as well as the common issues that impact the health of our society.
With healthcare becoming a costly affair, many cannot afford it. Company coverage and health insurances are still uncommon in our society. Many patients results in debts after one episode of hospital admission. In the paradigm shift of shorter hospital stay and the prevention of hospital readmissions, nurses have a huge role to play in the healthcare team in the area of patient education. Quoting what the nurse researchers Christina Dempsey and Barbara A. Reilly said in The Online Journal of Issues in Nursing, “Nurse Engagement and patient experience are not ‘nice to haves,’ nor are they considerations to address ‘when we have time.’ As the data and research have demonstrated, nurse engagement is critical to the patient experience, clinical care quality, and patient outcomes. Allocating exclusive time for patient education by nurses are uncommon and are left at the mercy of time after the “regular nursing work” which consist of administering medications, dressings, sample collection, checking vitals and so forth. The reasons that could hinder nurses spending time in this area may include work overload, lack of proper communication techniques or even lack of administrative support from the Hospital authorities.
Patient education becomes a reality only when the whole healthcare team gets involved. Coming together with a plan on what to convey to the patients will ensure that they receive the right tailored information and individualized care. A well-informed patient will often feel more responsible and is likely to involve better in a more meaningful way in their care. Nurses’ taking up this expanded role as nurse-patient educators is not a new practice. It has been embedded in nursing since the beginning of Nursing but only a few take up this role exclusively. More nurses should embrace this area of service as the need is high. The patients and family members’ active involvement in the care results in more patient satisfaction as well as improvement in the quality of care.
