5 tips to help nurses improve patient education skills
In today’s health care environment, nurses must provide patient education as part of routine care to improve the likelihood of positive outcomes.
“There is a new emphasis on better discharge planning, patient self-management of chronic disease, and patient engagement, said Beth Stuckey, RN, MS, CNE, assistant professor, nursing at American Sentinel University. “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.”
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Stuckey says patient education, like most nursing competencies, is a skill that develops over time, and it takes practice and commitment. “Patient engagement should not be considered a one-time event, but rather part of an ongoing conversation with your patients to be most effective.”
Stuckey offered the following tips to nurses to help them master the role of patient educator.
1. Take an individualized approach.
The most common mistake a nurse makes in patient education is teaching based on the patient’s medical condition rather than on the patient’s 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,” she says. Stuckey notes that when patients are in pain, medicated or experiencing emotional distress, their ability to concentrate and take in new information can be hindered. “So it’s important to assess the patient’s physical, psychological, and cognitive readiness to engage in learning,” she adds.
2. Keep the education patient-centered.
Stuckey says it is critical nurses provide information in the patient’s language or preference.
“It’s important that nurses never assume that just because a patient speaks English that they can read or write in English. And never assume that the patient’s family members can interpret what you are teaching.” Best practice supports the use of a professional interpreter to assure patient understanding and, therefore, increase the odds of success.
3. Support your patient’s ownership of health.
In the new health care landscape, nurses no longer simply tell their patients what directions to follow. Now they make the patient an integral part of the team. “It’s our responsibility as nurses to advocate for our patient’s rights and help them to voice their thoughts, opinions, and ideas, rather than just give a list of directions to them.”
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She says a nurse’s goal is “adherence” to the discharge plan, in which the patient is an active member in its creation. The terms “compliance” and “non-compliance” connote a paternalistic approach that the patient is either following or not following direction dictated to them.
4. Use the teach-back method.
When giving discharge instructions or teaching a patient how to dress a wound, Stuckey says it’s easy to fall into the trap of asking, “do you understand?” and being satisfied with a nod in response. She says this is not an effective way to gauge a patient’s comprehension of knowledge or mastery of self-management skills. Instead, studies from the American Medical Association validate and experts recommend using the teach-back method.
The teach-back method involves two-way dialog, which allows a nurse to more easily reinforce health information. When a nurse finishes teaching, they ask the patient to explain it back to them in their words.
“Likewise, when you finish demonstrating a procedure, nurses must ask the patient to demonstrate it on their own,” she says. This practice helps a nurse determine where the gaps in the patient’s knowledge exist and works to connect the dots.
5. Use patient interactions as opportunity to teach.
There can never be enough communication when nurses educate their patients. “We never know when will be the right time to discuss a topic and if that patient will absorb what we are teaching, so it is important to approach teaching in different ways and different times,” she adds.
Patient education and career advancement
Stuckey points out that nurses who discover they have an aptitude and passion for patient education can pursue jobs that allow them to put this critical skill to good use.
She says it’s a win-win situation. “Nurses can advance their careers while providing enhanced care to their patients.”
Home health nurses often engage in patient education at a higher level than do traditional bedside nurses and teach patients how to care for a PICC line or ostomy pouch.
In addition, hospitals are currently adding positions that put nurses in charge of post-discharge care and instruction. Nurses can even find work in a private physician practice as a diabetes educator or prenatal educator and pharmaceutical companies and insurance companies also hire nurses to act as patient educators.
“I would be remiss if I didn’t mention the significant shortage of nurse educators. This field is the best of two worlds – teaching and nursing. I encourage all nurses interested in continuing to learn about their profession in order to prepare the future of nursing to pursue a degree in nursing education. We would welcome them with open arms.”
The first step for a nurse to fine-tune their career is to empower themselves with knowledge. American Sentinel University is an innovative, accredited provider of online nursing degrees, including an RN to BSN program and advanced MSN degree programs with focused coursework that helps prepare nurses for a career in case management, infection prevention and control, nursing education, informatics, and nursing management and organizational leadership.
Learn more about American Sentinel’s online nursing degree programs at www.americansentinel.edu/nursing.
COVID-19 "causing mass trauma among world’s nurses"
Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels.
Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it.
What does it mean to be suffering from burnout?
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care.
While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.
Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them.
Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness.
How widespread is this problem?
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions.
Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.
Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses.
Have either of you experienced burnout?
Rindt: I have experienced burnout as an RN. I was constantly fatigued, never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.
Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job.
I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.
What impact is COVID-19 having on nurses' wellbeing?
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.
New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators.
However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.
How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?
Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.
Nurse burnout not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes.
Strategies to address burnout include training improving nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals.
What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.
Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously. We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.