Provision of Effective Patient Education: A Learning Clinical Experience
Submitted by Nighat Karim
(BScN Student at Aga Khan University School of Nursing and Midwifery)
Patient education is one of the fundamental aspects of holistic nursing care. It empowers people towards health seeking behaviors and self care leading to a healthy life and smooth recovery. Patient education plays a vital role in all the aspects of care from prevention to treatment. Nurses educate the client as well as their families by providing information that is understandable and appropriate promoting awareness and optimal health (Beta, 2014). Therefore, nurses need to recognize the significance of patient education. However, it has been observed that ineffective patient education is the most common source of a patient’s complaint in the healthcare sector (Aghakhani et al., 2012). The provision of effective patient education is a significant yet challenging task for the health care professionals.
Similarly, during my community rotations, I have encountered a 51 year old female patient living in a nuclear family. She has 2 children. She is a known case of diabetes mellitus and hypertension for 7 years. During history taking, the patient verbalized that she was having pain in her legs and abdomen, but, didn’t go to the clinic for a checkup. When the symptoms begin to get worse, she opts for visiting the clinic. After general assessment and other diagnostic procedure she was diagnosed with fibroids in the uterus. Therefore, the doctor recommended hysterectomy. After the surgery, the patient was in stress because she had a lot of responsibility to look after her mother in law at home. For that reason, she didn't have time to go for follow up visits. After 3 months of hysterectomy, the client shared concerns regarding health maintenance following hysterectomy at home. I shared some of my knowledge of hysterectomy care, such as avoiding strenuous exercise and eating calcium rich foods. However, the client was asking more questions about the diet, physical activity, screening test and follow-up visits. At that time, I was unable to answer her queries and told the client that I will teach you about hysterectomy care on my next home visit. Looking at the scenario, it reflects that I was unable to educate the client regarding hysterectomy care.
Nurses play a major role in hysterectomy care, because it not only focuses on the biological and medical aspects of care, but also on the emotional aspects. Therefore, such care requires a comprehensive education that will enable patient's to be independent in self care (Beta, 2014). Reflecting back to the scenario, initially, I was feeling good at the moment because I was able to build such a trusting relation with her that she shared her feelings and concerns with me. Moreover, I was able to identify the teaching needs of the client. However, after this incident, I reflect that I was not able to provide sufficient and complete information regarding hysterectomy care to the patient. As the patient was in stress and immensely concern about the hysterectomy care, I felt downhearted that I was not able to help the client to alleviate her stress. At that time, many questions were running in my mind that why this incident happened, why I was unable to educate the patient?
From this scenario I analyze that this incident happened because of several reasons. Firstly, I was not having enough knowledge regarding hysterectomy care. Due to the lack of knowledge, I was unable to educate the client regarding it. According to Aghakhani et al. (2012) good education skills are particularly important in the diagnosis, treatment and management of diseases. Secondly, I had less experience in dealing with patients with a hysterectomy in my clinical rotations. Therefore, it was challenging for me to educate the client on this sensitive issue. Similarly, in one of the study it was also reported that the nursing students encounter numerous barriers in patient teaching such as, low knowledge, lack of clear objectives as well as lack of clinical exposure (El-Demerdash, Basal & Soliman, 2014). Another factor is less confidence. Since this was my first day of community rotations, I was not confident enough in educating the patient. These all were the reasons that led to this incident.
In my view, if this kind of situation occurs in the future, I have to work one step forward. On next week of my community rotations, I gave teaching to the client regarding hysterectomy care with the help of pamphlets. On evaluation, the client showed positive response to the teaching. As now I have knowledge regarding hysterectomy care, I am confident in implementing the theoretical knowledge into practical settings through effective patient education. According to Aghakhani et al. (2012) effective patient education can be achieved through the use of an open communication style, written instructions and addressing barriers. Moreover, this experience and knowledge will help me in future in implementing the teaching in a short period of time. Secondly, I will assess the learning needs of the patients through history taking and formulate a comphrensive teaching plan. According to Beagley (2011) presenting a well-formulated plan will increase the likelihood of a successful recovery for the patient. Moreover, I will utilize various strategies in patient education according to their learning style for better understanding of the content. Effective education strategies include handouts, pictures, pamphlets, demonstration and rephrasing key points (Beagley, 2011). Thus, the scenario could have been changed if complete information and guidance for follow-up visits were provided to the patient.
In conclusion, patient education is one of the most crucial aspects of nursing practice. Student nurses faced many challenges and barriers in educating patients, such as low knowledge, lack of clinical exposure as well as lack of confidence. Therefore, through effective patient education nurses can increase the responsibility and independence of client for self care in hospital as well as in community settings. Thus, by applying overall strategies, I can improve my mistake and I will implement effective patient education skills in my clinicals.
Aghakhani, N., Nia, H., Ranjbar, H., Rahbar, N. & Beheshti, Z. (2012). Nurses’ attitude to patient education barriers in educational hospitals of Urmia University of Medical Sciences. Iranian Journal of Nursing and Midwifery Research, 17(1), p.12.
Beagley, L. (2011). Educating patients: Understanding barriers, learning styles, and teaching techniques. Journal of Peri-Anesthesia Nursing, 26(5), pp.331--337.
Beta, G. (2014). Patient Education – Relevance in Nursing Education and Practice. American Journal of Educational Research, 2(7), pp.441-446.
El-Demerdash, S., Basal, A. & Soliman, F. (2014). Barriers of Patient Health Teaching among Nursing Students. International Journal of Current Research, 6(1), pp.4770-4776.