by Ginger Kanzer-Lewis RN, BC, EdM, CDE

In the complex world of health care, learning never stops. With all the new treatment modalities, new concepts, and ever increasing medication formularies, “keeping up” every day is a challenge.

In order to protect patients and our own credibility, all of us must become part of staff development. Teaching colleagues is not always easy or considered part of our jobs, but we no longer can say it’s the staff development educator’s role alone. So how do we start and how can it be done in a world of nursing shortages, economic shortages, and time constraints? Where is our responsibility and accountability?

First, let’s clear something up. Staff education is not part of the formal teaching programs the staff development department does in classrooms, on the unit, or in the department. Staff education is the informal teachable moments done co-worker to co-worker or peer to peer. It can be done effectively, efficiently, and without becoming a burden. It doesn’t require formal class outlines or educational materials. You know what you know and that is what you will share with a colleague.

Staff development vs. staff education

In my experience as director of staff development or education, it was always known that my department was responsible for the education of the staff. We did the orientation of new employees, the ongoing in-services of new equipment and policies, and continuing education from 1 day to 6 week courses for the staff. We were “the experts” and everyone came to us.

Somewhere along the line I began to wonder how people came to believe that we were so smart and everyone else knew nothing. That made no sense to me then and still doesn’t. It’s certainly timely for us to consider staff education as a major professional responsibility for everyone.

“If we all make a commitment that our staff will be the best, there is a better chance it will happen.”

Whatever role you fill; dietitian, nurse, physician, pharmacist, physical therapist, social worker, or anyone I missed, this is what makes the difference between a health care professional and a caregiver! I have said that before about patient education and it certainly holds true for the education of the people who take care of patients.

I then ask the same questions and hope to suggest some answers that will help you do it and perhaps even help you enjoy it. That said:

• Just how do you get it done?
• How do you get everyone to do it?
• How does everyone learn to do it?
• How do you do it without it being a burden?
• How do you do it quickly and effectively?
• How do you prepare?

Step 1: Make staff education a facility-wide policy

If we all make a commitment that our staff will be the best, there is a better chance it will happen. If senior level administration establishes a policy that everyone is responsible for staff education, then this becomes part of the organization culture. But if the administration believes that only the education people are responsible for staff education, then there’s no commitment from anyone else. The only people who will teach staff, outside of the staff development department, will be the ones who always thought it was important and they will get little or no recognition for doing it.

I believe that education should be included in the job description of each employee and everyone should be held accountable that it is done. It should be a criterion on performance appraisal forms and scored the same way or even higher than most other evaluation items.

In some facilities there are levels of excellence in the organizational structure. Staff who include teaching in their job responsibilities are called preceptors or they’re graded at a higher pay level. This is how the organization recognizes their commitment and worth to the organization.

“Most educators are more than willing to share their ideas and methods and are pleased to mentor fellow health professionals.”

In contrast, even in a small workplace, there is always the person who is ready, willing, and able to take on that responsibility without compensation or recognition. They do it because it is easier to work when everyone pulls their part of the load. Many times they do this because they enjoy teaching and because sharing professional knowledge is something that’s important to them. They are very special people.

I’ve asked registered nurses, who really needed to be doing something else at the time, why they were doing something that a nursing assistant could do. The answer was often, “It’s easier to do it myself than teach them how to do it.” WRONG ANSWER!

If you teach additional staff to do something, whether it is a peer or an ancillary staff member, they will do it and leave you time to do the things that only you can do. Here’s the point - by law or by education, I can do everything they can do but they can’t do everything I can do.

In addition, the best way to become an expert in something is to learn to teach it, plus the teaching will reinforce your own skills.

Step 2: Make sure everyone has the skills to teach staff

This is not guaranteed by professional credentials. Patient education is now included in the curriculums of most health care professionals. They are taught to teach patients and are expected to do it as part of their educational sessions. However, no one teaches you how to teach staff and it is often not included in master’s programs unless the degree is in education.

Many of us have had the experience of working with incredible health care professionals who know and can do anything, but ironically can’t teach anyone anything. That’s not a disgrace. Teaching is a skill. You can overcome this by using the staff development department of your facility. These are the experts in adult and patient education and they should be preparing all staff for the skills they need.

If you represent the staff development department and conduct classes on how to teach, keep them short and do them on the units so as not to create a burden. If a longer program is warranted, it should be done for continuing education credits so there is an additional incentive to attend. Invite all departments so everyone can benefit.

Most educators are more than willing to share their ideas and methods and are pleased to mentor fellow health professionals. There are many resources now available, wonderful articles written by health educators in all fields, websites, workshops, and excellent books. Seeing a need and having a desire to share with colleagues what I learned over the years motivated me to write my book, Patient Education: You Can Do It!

Step 3: Do it without it being a burden

When you do something and know that a staff member has never done it, invite them to watch or assist you. Offer to help them finish one of their own tasks so they have the time to join you. Invite more than one staff member if possible and don’t hesitate to show an assistant, aide, or technician to watch and see what you are doing and why you are doing it.

It doesn’t diminish the staff member if you teach them something. Education elevates everyone and including people of all levels is team building.

Step 4: Don’t hesitate to share throughout the facility

Years ago I was called in to help a hospital develop patient education materials. I asked the director of nurses what they already had done and she assured me that nothing existed. When I made rounds on all the units, I found that each specialty had developed their own materials and used them constantly. I found that these materials were often well done and quite accurate. It was astounding to both of us that each department had done something so wonderful and kept it to themselves. They eventually published the materials hospital-wide saving a lot of work and time.

“The bottom line is you can teach people without adding hours to your day.”

So find out what is already being done in your facility. Remember the department head may be the wrong person to ask. Staffs often do things that make their lives easier rather than going through the chain of command or bureaucracy that often exists in the workplace.

There are now clinical manuals in all fields that contain teaching tools. There is also a policy and procedure manual in most work places. OSHA requires it and if you don’t have one, that’s a job that needs doing. The most important thing about policy/procedure manuals is to know where they are located and what is in them. Read the table of contents so you know what exists. When you start to teach a skill, pull out the book and have the learner go through the steps with you.

Step 5: Be careful in your approach

It’s important that you don’t make the person feel inadequate, stupid, or defensive. A head nurse came to my office to tell me one of her nurses was having difficulty doing a specific procedure. I said I’d go to the unit and review the procedure with her. The head nurse didn’t want to embarrass the nurse by telling me who it was. I suggested that if she thought I was going to go to the unit calling out for any nurse who could not do a CVP line; she had the wrong person. So we stopped playing games and she told me who needed help.

It worked out well once I knew who I needed to teach. I took out the procedure book and we reviewed it together. It only took a few minutes. Two other staff members joined us and they even made some excellent comments and suggestions. They do that procedure much more often than I do and could have taught their colleague just as well. The bottom line is you can teach people without adding hours to your day.

Step 6: Doing it quickly and effectively.

The biggest mistake health care providers make is that they try to teach colleagues everything they know. You can’t teach 10 years of learning in 10 minutes and it really doesn’t pay to overwhelm someone and turn them off to learning.

I call it the Do-Know-Deficit

• What do they have to do? i.e. take medication, change a dressing, etc.
• What do they need to know in order to do it? i.e. side effects of the medication, aseptic technique, etc.
• What do they already know? Ask them, have them show you, and validate that it’s correct.
• Teach the deficit. Give the person the respect they deserve and find out what they already know. Don’t waste their time and yours by teaching them something they already know.

Staff teaching shouldn’t be an option

It’s clear and simple that staff education needs to be done and shouldn’t be avoided because time is tight and staff is short.

• If the facility makes it a policy that it will be done...it will be done.
• If the staff is taught how to do it and integrate it into their daily routine…it will be done.
• If the burden is removed so it can be done quickly and effectively…it will be done.
• If everyone works together to plan and deliver one-on-one colleague education…it will be done.

Try it. You might just like it and improve your own skills and knowledge at the same time. Good Luck!