How can you get nurses to teach patients and families?

How can you get nurses to teach patients and families? I was asked this by a neonatal clinical nurse specialist. Here’s the response I sent her:

Great question. How can you get nurses to teach? It depends on what the problem is.

– Do they know how to teach? Have you measured competency? Do they know how to assess the learner, individualize teaching, and evaluate understanding?
If this is the problem, give them the skills.

– Do they lack self-efficacy related to teaching?
If so, explore the areas in which they lack confidence, and help them gain confidence through your usual staff development techniques. Perhaps they are new nurses unsure of their own skills.

– Do they recognize that neonatal nurses have advanced skills in taking care of the little ones, and the families have no training and are expected to pick up care at home where the nurses left off?
These parents, especially, need to understand how to safely care for their babies, know signs of a problem, and know how to respond when the identify a problem.

– Do they not think it is their job to teach?
Is it in their job description? If so, hold them accountable for teaching. Evaluate their performance based on evidence of teaching: documentation of evaluation of understanding. If they do not provide evidence that they evaluate the understanding of, in your case, families, through teach back and return demonstration, there is no evidence they taught.

Have you struggled with the same issues? Are there other reasons nurses don’t teach patients and families? Are they not teaching, or are they just not documenting their teaching? What have you done to address this problem?

9 Responses to “How can you get nurses to teach patients and families?”

  1. Mary says:

    We are trying to go electronic with our patient education record to make it more available to the other disciplines. Can you give me an example of measuring nursing competency for patient education?
    Something we can do hands on in a classroom or on the units?

  2. Linda Hensley says:

    Sounds like a great book not just for nurses but applicable to other disciplines who interact and provide patient education as well.

  3. Debbie O'Connell says:

    We are moving toward “teach back” for patient education. Does anyone currently use this patient education process and if so, how did you implement?

  4. Yes, indeed Linda, not just for nurses! The whole title of the book is; No Time to Teach: The Essence of Patient and Family Education for Healthcare Providers.

  5. Mary, there are a few basic skills related to patient education: assessment, individualization of teaching, and evaluation of understanding. According to Donna Wright, a good way to evaluate competency is to observe the behavior, or gather evidence that the behavior occurred. A good way to measure competency on the units is to check documentation. For example, was it documented that the learner return demonstrated the self-care skill accurately? Was it documented that even though the learner spoke English enough to get by, an interpreter was used to ensure the nuances of teaching were communicated?

    In a classroom, you could ask the nurse to talk about a detailed example of when an assessment led to individualized teaching. These techniques could be used with all disciplines.

    Source: Wright, D. (2005). The Ultimate Guide to Competency Assessment in Health Care (3rd ed.). Minneapolis, MN: Creative Health Care Management.

  6. Debbie, our documentation asks the level of understanding the learner demonstrates (no understanding, general understanding, detailed understanding, or able to solve a presented problem). In order to document patient education, it is necessary to evaluate understanding through teach back or return demonstration. There is no box for “learner nodded indicating he understood.”

  7. Bruce says:

    Debbie, our documentation asks the level of understanding the learner demonstrates (no understanding, general understanding, detailed understanding, or able to solve a presented problem). In order to document patient education, it is necessary to evaluate understanding through teach back or return demonstration. There is no box for “learner nodded indicating he understood.”

  8. Thank you, I love it.

  9. An extremely interesting tip! I enjoyed reading it a lot! Good job you’ve done

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