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

2 Responses 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.

  2. Tammy Ward says:

    This is a very interesting perspective to have as a nurse educator that gives great insight into how the patient feels and thinks about what we as nurses do that is helpful or not so helpful. Minor adjustments to our delivery can make a huge difference.

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