Does how you view your job determine your attitude toward patient education?

It puzzles me that not every health care provider is as enthusiastic about patient and family education as I am. Why isn’t is obvious to all that, after saving lives, our most important service is patient education?

So I asked. I listened. I thought.

I now have a theory: How you view your job determines your attitude toward patient education.

Let’s test it. Which of these two best describes your view?
1. I am an expert. I know right from wrong. If you do what I tell you to do, you will get better.
2. I am a professional. My field is constantly changing and I am always learning. I can help you get better.

I propose that if you see yourself as number 1, you sometimes get frustrated with patients. They tell you their problems, you offer them a fix, they don’t follow your advice, and then they complain about the same problems the next time you see them. Why do they bother coming to you if they don’t want to do what you say? It’s just a waste of time and resources.

I propose that if you see yourself as number 2, you view your frustration with patients as a sign that you need to understand them better. When you are frustrated, it means you are imposing your values and goals rather than helping them reach theirs. What does the patient want? How can you help the patient get there?

Those with the first point of view define patient education narrowly, as instructions and directions. One-way communication. Those with the second point of view define patient education more broadly, as providing information, instructions, and coaching. Conversation and negotiation.

What do you think? Does this make sense?

I’m wondering if this theory could help us when we teach patient education skills. Do our learners see themselves as health care experts or health care professionals? Should we first assess their point of view, so we could adjust how we present the content?

Is there a difference between a health care provider that labels a behavior as “non-compliance” from one that calls it “non-adherence?” And most importantly: which point of view produces better health outcomes?

©2011 Fran London, MS, RN

8 Responses to “Does how you view your job determine your attitude toward patient education?”

  1. Sandy Cornett says:

    Right on Fran! I wonder if there is an instrument that could be administered to health professionals to ascertain their attitudes (not just prior knowledge or skills) toward patient education. I’ve only seen tools looking at knowledge and skills, but attitude and how we view our relationship with patients is the key.
    Sandy

  2. Thanks Fran, You hit it right on the nose! It’s something healthcare providers should think about and a question we should be asking as we work with them. Maybe then they’ll realize how their attitude impacts patient education.

  3. Kim Hume says:

    Fran,
    Your insight continues to amaze and challenge me. As we continue to strive to become more family focused, having the attitude of “I am a professional. My field is constantly changing and I am always learning. I can help you get better.” puts the patient and family in control. As much as we might like to ‘make’ our patients healthy, the work and lifestyle changes needed to progress towards better health are theirs alone. We can coach, mentor and help, but the patient must remain in control.
    Kim

  4. Wayne Neal says:

    Fran this is a good discussion, I agree with you and the professional in me tends to lean toward my values and how I grew and continue to grow as a professional nurse. The schools of nursing are so differnt now. I have read several articles on nurses as teachers and most of them allude to the fact that nurses are not prepared to teach patients and families. And you are right its about the nurses plan and not planning with the patient/family.

  5. Bonnie Ronan says:

    This is a wonderful, thought provoking theory in helping me to understand why promoting effective patient/family teaching is not seen by all staff to be the priority I see it to be. I was especially drawn to your comment about “non-compliance” vs. “non-adherence.” I believe there is a big difference and it is seldom addressed – especially by the “experts.” Thank you for stretching my brain cells a bit!

  6. Wow, this generated quite a response. Thanks, all, for your comments.

    Sandy, I don’t know of such an instrument to measure these attitudes, but you might want to consider creating one. It looks like folks agree this is a valid correlation.

    Wayne, I didn’t know that about nursing schools not preparing nurses to do patient education. If true, we need to change that. How?

  7. Christine Hess says:

    Great perspective, Fran! I find this absolutely true and powerful. It not only is applicable to our professional interactions, but also to our personal ones, our daily way of life. Many of us in education feel strongly about being life-long learners. So our minds are open and we communicate with the attitude of wanting to explore and share-not “Listen to me, I know best.” It will effect the way you learn, and teach!

  8. Sallie Weems says:

    Hi Fran- I just stumbled on your blog, and this first post I read fascinated me. Too many healthcare providers still fall in the 1st camp- especially with the current focus on readmissions. I like the idea of incorporating patient education as part of the nursing curriculum.

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