Getting Through the Gobblydegok

My Mock Literacy Research survey "Addressing the Nurse to Patient Education in the Hospital Setting" has become quite an undertaking. The purpose was to address the comfort level of nursing staff in educating patients to allow the patient to have the information they want and need to participate in making informed choices regarding their health care.

First, I would like to comment on the comments of my non-nursing classmates who took on the role of criticising the survey. Their comments prove that "you can not tell a person's health care literacy by education level or profession. The jargon often gets in the way of the message.
Next, my nursing colleagues appeared to immediately see where the survey was headed. Some commented "who is doing this survey and what will I be required to do NOW?". Others thought the survey could be useful for in services (particularly with new Joint Commission and Nursing Board CEU requirement). Still others said, "there is just not enough time why do we nurses ALWAYS have to provide information?".

The gap between physician and patient often requires a nurse to intervene in health care knowledge. The Columbia University School of Nursing website is a stellar example of nurses taking control. The weakness in all of the assessment tools appears to be "the exceptions". Barriers such as willingness to learn, ESL, cognitive challenges (dementia, hearing, etc.), often seem to go hand in hand with compliance to a prescribed health care regime either through personal commitment or financial considerations. There is always THE TIME FACTOR.

Perhaps follow up phone calls by the facility would be beneficial for those who do not qualify for home health care follow through. The hospital could expand community out reach topics. Bottom line-nurses must be provided the skills, tools, and time to educate if financial re-reimbursement is to be considered tied into the discharge instruction mix. The other possibility is a return to the Primary Nurse responsibilities that offered a continuing education. Yet the weakness in that scenario is the present 23 hour observation status of many patients.

I return to the ASKme3 program that provides basic information while allowing for an expansion IF THE PATIENT DESIRES. A timely article is Safeer and Keenan's "Health Literacy: The Gap Between Physicians and Patients", American Academy of Family Physicians. 2005.

My bottom line as a nursing professional is that nurses (and hospitals) should not be penalized for patient non-compliance when the patient makes an active informed choice to not live with a prescribed health care regime.