Going undercover for patient education

Yes, I went undercover in one anecdotal situation to see for myself the current status of patient education.

When I learned I need a hip replacement, I did my usual research.  I asked friends to describe their experiences, and for advice.  I searched the Internet for information and suggestions.  Wrote my list of questions for the surgeon.

When I had my hip replaced, I only revealed to my professional caregivers that I had been a registered nurse at a children’s hospital (true).  I did not announce my specialization in patient education.  This gave me the opportunity to venture into investigative reporting.

Here are my findings:

— The surgeon’s office provided in conversation clear and helpful preparatory information, and answered all my questions.

— The hospital provided a free class a week before my surgery.  Content included what to expect pre-op and post-op, how to use a walker, and a tour of the unit.  Booklets were provided.

— Registered nurses always told me what medicine they were giving me and why before administration.

— A folding stool hung on the wall of my hospital room.  It was labeled, “Care Team Seat:  We Are Here To Listen.”  Indeed, during my stay, a nurse and a doctor took the stool off the wall and sat on it to talk to me.  For a photo, go to:


— I was asked to demonstrate use of the incentive spirometer.

— Twice, teach back was used.  Once by a physical therapist and once by a physical therapy assistant.  However, both times teach back was used at the end of a session, testing me.

I learned first hand how important it is to use teach back as a check to see if you taught well, not a test to be sure the learner understood.  Both times the teach back made me uncomfortable.

I had a lot to think about when learning how to walk with a new hip.  I was still processing all the details when I was asked to teach back specifics.  In addition, since they knew I was a registered nurse, I felt even more pressure to get it right.

If instead, the therapist said, “I want to make sure what I told you was clear . . .” I would not have felt so threatened by the request to teach back.  Really.  It sounds like a minor adjustment, but it would have made me a lot more comfortable.

— As prepared as I was, I did not realize until I got home that I was not given the phone number of any nurse or doctor to call outside of office hours if I had a medical concern to discuss.  And of course, I had a question on a holiday weekend.

— Over all, having a procedure like a hip replacement can easily become overwhelming.  So much to learn:  what to do before surgery, what to expect after surgery, what needs to be done over time before I can return to a normal life.  Although I was given many opportunities to ask questions, I did not know what I did not know.

If nothing else, I am more certain than ever that after saving lives, the most important service of health care professionals is patient education.  Everything I learned, and continue to learn, adds to the success of this new hip, and my ability to fully participate in life again.

©2017 Fran London, MS, RN

One Response to “Going undercover for patient education”

  1. Stephanie Williams says:

    I taught that this was a very interesting assessment of Patient Education based on your own experience. I can see how we can begin and complete the process of providing patient/family education.

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