Patient-family-community education: no longer frills

Patient-family-community education: no longer frills

Marilyn S. Fetter

Patient-Family-Community Education: No Longer Frills

When adult health nurses speak about their most rewarding professional moments, many describe a special encounter teaching a patient or family member how to manage symptoms, cope with illness, or prevent disease. Knowing that you have “made a difference” in someone’s life is in large measure why many of us became nurses. As professionals, we have the expertise and special skills needed to provide information on managing illness and promoting health. While care associates have been assuming added responsibilities and functions formerly in the domain of the registered nurse, most experts agree that aides and technicians are not prepared or capable to provide the education patients and families now need. Through health education, medical-surgical nurses play a vital and fulfilling role across adult health settings. As health care undergoes many transitions, it is critical for nurses to reaffirm and redefine their role as health educators.

My views on the health education role of nurses come from varied sources. Since my earliest days in oncology nursing and in my work with the seriously and persistently mentally ill, I have learned to value patient and family perspectives with regard to managing symptoms. In chronic illness, patients, families, and providers need to work as partners, sharing information and responsibilities. Nurses are central to the mission of promoting optimal levels of health and functional status in these patient populations. Information needs are constant and evolving; health professionals must be responsive and ready with facts and resources. Improvisation is a regular occurrence when a new side effect or an unusual response catches everyone off-guard.

Improving Patient/Family Education

As a faculty member and course leader for an innovative Health Promotion Course required of senior nursing students, I have enlarged my vision of the possibilities for patient and family education to encompass neighborhoods and communities. In theory class, our students learn about models of health promotion, strategies to promote health with individuals, families, groups, and communities, and advanced teaching-learning theories and approaches. In a 7-week clinical practicum, students target learner populations, assess needs, develop and implement programs, and evaluate outcomes. They present their work at a university-wide poster session. In truth, these seniors do not always relish the prospect of this course at its start. Almost universally, they come to cherish and value the content and experiences. Increasingly, graduates remark that they feel fortunate for this opportunity and feel that they have an advantage over students prepared more traditionally. These students know that the shifting focus on rewards for keeping people well demands a sound preparation in the principles and techniques of patient-family-community education. Nursing programs across the country are revising their curricula to include and expand theory and clinical content in these areas. However, many nurse experts in the field of health promotion are concerned that nurses currently in practice “may have missed the boat” and are inadequately prepared to provide effective patient-family-community education. How can medical-surgical nurses in general and AMSN in particular address this challenge?

All good health educators know that people learn in three domains — cognitive, affective, and psychomotor — and nurses seeking to enhance their patient education expertise must master objectives in each of these areas. Most importantly, adult health nurses must value patient and family education. In my view, this affective goal is critical to our specialty’s success. We must establish ourselves as the educators of choice with the people who really count — patients and families. Each client encounter must be viewed as a teachable moment. We must answer patients’ questions, such as “How can I reduce the effects of my known risk factors? What is the best way to stop smoking?” And, “How do I find the best nursing home for my mother?” We must appreciate that our services are valued most when we practice at the highest levels of professionalism. Sending someone home from the hospital with inadequate or inaccurate information, even if we “don’t have time” won’t cut it anymore. We have to find the time.

In the cognitive sphere, we must know more and know how to learn more. We must be able to explain in everyday language what every man and woman needs to know about managing health and disease. We must know what we don’t know, admit it to ourselves and our patients, and be committed to lifelong learning and growth. We must learn how to find the information resources we need and use them. We must learn how to access resources via the Internet, telephone help lines, libraries, journals, and even newspapers. We cannot rely upon a hospital nursing education department any longer. The responsibility is ours to stay on the informational cutting edge. We also have a responsibility to insist that as hospital and agency employees, we receive the proper training to use new tools and technologies appropriately, correctly, and efficiently.

We must become more versatile in the psychomotor skills necessary to do the job of medical-surgical nursing. As an organization, AMSN can play an important role in identifying standardized expectations and competencies for a wide range of skills required of adult health nurse specialists and generalists. These range from technical skills used to provide patient care, to computer skills used to document care and retrieve information. By understanding what are the core competencies, we can identify and support colleagues who need more education and training to do the job right.

MEDSURG Nursing is deeply committed to improving patient and family education. At our 1996 Editorial Board meeting, we brainstormed about ways to enhance the journal’s role in cultivating nurses’ knowledge and skills about the structures, processes, and outcomes of health education. We are including more information about this vital nursing role in every journal article and column. In this issue, O’Halloran provides a comprehensive overview of client health teaching which should aid nurses in shoring up their knowledge base. In coming issues, we will be addressing important issues such as the role literacy level, socioeconomic, racial, and cultural factors play in health education. Patient-family education is the core of professional nursing, and medical-surgical nurses can become leaders in strengthening its place at the bedside.

COPYRIGHT 1997 Jannetti Publications, Inc.

COPYRIGHT 2007 Gale Group