Nursing Voices

Thursday, April 05, 2007

Old School: Bygone Days of Patient Education

What’s going on here? This looks vaguely familiar. Wait a minute, I remember, it’s called patient teaching. This is a visiting nurse teaching a new mother how to make formula for her baby. I know this is going to come as shock to many younger nurses, but we use to have lots of time to do patient teaching. Nurses would spend hours doing 1:1 teaching at a patient’s bedside, but those days are gone. Now we barely have enough time to learn our patients’ name before their HMO pushes them out the door.

My first job as a psychiatric nurse was a dream come true. I had time to really talk to the patients, and to listen to what they had to say. Each staff member created a group based on our own area of personal expertise. I am the queen of bargain hunting, and since many of my patients lived on a fixed income, I created a “shopping group,” in which I taught patients how to create a budget and shop for the best deals. During the winter months, my patients and I clipped coupons, and we studied the local newspaper and penny saver paper looking for good deals. When the weather was nice, the occupational therapist and I would take the hospital van and drive patients to yard sales, flea markets, and thrift stores as a way of teaching them how to stretch a dollar. We had the patients make up a shopping list, and then we would give them money to buy their items. Today's HMO companies would never reimburse a hospital for that group. HMO won’t let us take patients out anymore because “if they are well enough to go outside of the hospital for a group, they are well enough to go home.”

Since hospitals are demanding that nurses do more work with less staff, I’ve created this group that takes into account the time constraints placed on busy nurse’s schedule. I estimate that a nurse can complete this 1,2,3, Zing group in about 15 minutes. Maybe the insurance companies will pay for it if we document the activity as a socialization or nutrition group. Things go better with Coke.


Blogger Gerbil said...

I'd call 1,2,3-Zing a life skills group... unless your census is full of coke fans of a different kind, in which it could be relapse prevention.

3:42 PM  
Blogger poody said...

Even in home health nursing if you are dealing with a HMO they only give you like 2-3 visits for teaching for a new dx diabetic. It is difficult to get it all taught in a way they wil retain information in that amount of time. I take my patients that can get out to the grocery store and teach them how to read labels!

4:53 PM  
Blogger MadMike said...

Health care in America! What a dream, or is that "nightmare.." Great post MJ.

6:08 PM  
Blogger jaz said...

It really makes me sad when I think about how bad things are right now in this country in regards to health care, public health, mental health, social justice... and we're stuck in it, aren't we?

I mean, nobody on the receiving end of the money is going to turn around a multi-billion cash cow just because it's "the right thing to do."


6:49 PM  
Blogger Laaw-yuhr said...

HMO/Insurance is the devil. I've just had my sinus surgery cancelled because it has not been deemed "medically necessary."

10:32 PM  
Blogger ~mika~ said...

So, I am spoiled b/c I have the time to teach my patients. Man is it going to suck if I go back to being a civilian. Great Blog BTW!

12:39 PM  
Blogger ~Autumn said...

I would love to teach the patients in my psych rotation about finances. Sooo many of them need it so badly.

3:28 PM  
Anonymous Anonymous said...

And then there are companies coming up with electronic ways of teaching patients. When you see the next animation film, you cant be sure it'll be entertaining... it could be about diabetes or hypertension as some companies like are coming p with. My doc handed me a DVD and it was sooo cool. Of course I had questions for him but this time they were intelligent ones :)

12:14 PM  

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