If you're reading this newsletter you obviously believe in patient education and know how important it is for people with health care needs. You may be an experienced educator or a person who is just getting started because your new job or profession requires that you teach patients something about their own health and care. Whichever category you fit in, I admire you and welcome you to the world of patient education.

We tell health care professionals to go and teach patients and give them neither the skills nor materials to do that job… the professional educator should take on the responsibility of educating the staff at each health care site…

In these times of nursing shortages and time constraints by managed care companies, how dare I suggest that you undertake a new and demanding responsibility? It's simple. Patients are entitled to be taught about the things that affect their lives. Our job is to give patients, people with a health care need, all the information they need to make decisions about what they will and will not do.

Don't fool yourself into believing that they will do exactly as you say just because you are the professional and told them to do it. The hardest and most important part of patient education is motivation. You have to convince them that what you want them to do is important to their life and worth the time and effort it takes.

The real truth is that for each health care provider, it is his or her legal, moral, and professional responsibility, but it cannot be done in a vacuum. Each colleague we work with must be held accountable for the follow through of whatever we have taught the patient.

When I, as a Certified Diabetes Educator, teach a person how to self-administer their own insulin, I leave instructions for that patient to be supervised by the person on duty when they get their next injection. It is never acceptable for that professional to give the injection to the patient because it is less time consuming to do it her/himself than to supervise or teach the person. If I allow that to happen and do not hold the professional accountable I am doing patients a disservice.

The only patients in hospitals who should be given insulin by staff are those who are unconscious or have both hands in casts. I may be exaggerating but the patient who never gives his own injections in the hospital will not be able to do it at home and will not have qualified supervision there when they need it most. I'm not talking about new diabetics alone. Any patient on insulin has to demonstrate an injection to me so I can validate that they've been doing it correctly. You cannot imagine the terrible techniques I've seen by someone who was taught once and never had follow-up.

We're all responsible for making sure that there is follow-up, whether it is in home health care, in the clinic, or the physician's office. If the patient in a hospital is taught about ostomy care, who will follow the patient at home? When you have finished with your part, is a referral made to the next person in the link of care?

…how dare I suggest that you undertake a new and demanding responsibility? It's simple. Patients are entitled to be taught about the things that affect their lives.

If this is so vital an issue and it makes so much sense, “Why isn't everyone just doing it?” To put it simply; people will not leave their comfort level. We tell health care professionals to go and teach patients and give them neither the skills nor materials to do that job. We do not teach them how to do patient education as a practical day-to-day experience and we do not make the copious amount of materials available where they work and when they need it. They have to go find it on their own in a time crunched workday. They won't seek this out on their own if it is a burden.

The professional educator should take on the responsibility of educating the staff at each health care site about what you have taught the patient so they can use the same language and meet the same goals. Can you share materials and knowledge with the other professionals in your community?

As Director of Nursing Education in a large hospital in New Jersey I was responsible for the education of 1300 RNs and 2700 employees. We could not require the staff to teach patients without giving them the tools. Each employee was scheduled to attend an all day workshop, on hospital time, “Patient Education: Just Do it!” This gave them the knowledge, attitudes and skills to enable them to teach patients. We then created education boxes for each unit with the materials, handouts and tools necessary to teach patients on many subjects. The education department kept the boxes current and filled.

We could not expect staff nurses, pharmacists and dietitians to develop curriculum and assemble educational materials. We also stressed that patient education must be incorporated in daily patient care and not considered a separate job that is done when time permits or there is extra staff scheduled.

When you change a dressing you teach about wound care. When you get a patient out of bed after back surgery you teach body mechanics and physical therapy. Where is it written that only patient educators educate patients? Nowhere! After they had participated in the course we could then hold the staff accountable for what they had been taught.

The hospital opened the classes to our colleagues in the community. Invitations were sent to physician's offices for their staff and the Home Health Care agency sent many of their employees. The entire process took a year and was very rewarding. It was possible because patient education became a JCAHO requirement in hospitals and that gave us the ability to budget for this extensive process.

Major Quality Improvement requirements for physicians' offices and clinical sites are now driving the same paradigm shift. This can be a community wide effort and the community hospital has the skills and staff to pull together the health care environment and help them join their resources to meet the needs of their population. They can undertake this leadership role, help meet the goals of the patients and alleviate the frustrations of health care professionals who see educational needs and have neither the skills, time, or resources to meet these needs.

To quote my favorite book, mine, “Patient Education: You Can Do It!” Have Fun!