There are a multitude of paths that you can explore during your nursing career. Usually, to start out, many pick the hospital setting while others choose nursing homes or doctor’s offices to name a few. However, whether you are a new or a “seasoned veteran” in your life as a nurse, two of the most important roles you will ever have is as a patient’s advocate and teacher. You are the patient’s hands-on caregiver, but you are also their voice and mediator when it comes to their stay in your facility or at home in a home care situation. You are the bridge between the doctor or doctors involved. You and others involved with each patient’s care, must see the patient as a unique individual.
Wherever you are caring for your patient, we need to remember that in a vast number of the general population admitted into healthcare facilities, they are not familiar with their surroundings. They are out of “their element”and for the most part are dealing with total strangers. Imagine how that feels to them. They may feel vulnerable, fearful, and along with their significant others may have many concerns that they are not sure how to express.
Perhaps they have only one physician caring for them, or maybe they have a whole list, but remember you fill the gap. The nurse is the patient’s sounding board and the bridge that connects all the channels in their care together. Listen to them. They are not just a medical number in a hospital room. They are why you went into your chosen profession in the first place and took the title of caregiver. Every patient has their own story, and it is important that we fit in time to get to know their stories and them as individuals. I know some of you are saying to yourself, “You have got to be kidding…I do not even have time to eat my lunch or use the bathroom.” One suggestion is to squeeze in some listening time while you are doing your head to toe assessment. During that time, ask them if they have any questions or concerns. Has anything been bothering them in their stay? I am positive that many of you have already created your own skills in questioning your patients with the little time you are allowed. Remember too, there are excellent nursing assistants out there that are part of the health team, and they may over hear your patient or their families or friends voicing some concerns. Talk to your nursing assistants and encourage them to play an active role in gathering important information. Just remember what is shared is always confidential.
Your patient and their significant others may want to know why the lights come on at 5am and the lab comes to take their blood at such an ungodly hour. They might want to know about the procedure the doctor has ordered in x-ray. Other top questions include: is it going to hurt, what are they going to have to do and what are the risks. Maybe they will ask you why their medication has been changed. This can signal to you that these are the questions the patient would like to ask their doctor(s) but are intimidated and don’t ask. Some of their questions are things you can answer but some are for their doctors to explain. Doctors cannot read minds! The patient may have specific questions they want answered. Some, for instance, may have heard horror stories from friends and relatives about a certain procedure or they have googled it to get answers to their questions and came up only half-satisfied or even more confused. When it comes to questions concerning medication changes, how many times has your patient zeroed in on only the adverse effects? Sound familiar? Make notes to the doctors and have someone, if you are not there, bring it to their attention…. teamwork! Also, have the patient keep a list of their questions at the bedside. Remember, we can feel intimidated with some of the doctors for one reason or another. Our patients may feel even more intimidated.
Doctors are not the only ones with a large case load and it can be very difficult at times to answer all the questions for your patient. Don’t ever miss the opportunity to reach out to others from the health care team or take the initiative to bring them on board if you see a specific need. There are therapists, nutritional advisors and social workers, to mention just a few, who are more then happy to talk with your patient about their area of expertise. Teaching is a very important role of the nurse and other healthcare providers and should never be ignored. Just remember to document what has been taught and by whom! Some specialty units have prepared packets that also can be used to inform and teach your patients; but beware that some patients may have cognitive problems which may prevent them from grasping what is on the printed page. There are also still some in today’s society who cannot read. Always do a follow up not only to allow your patients to ask questions but to assess their understanding of the material read.
Looking toward discharge from your facility, ask again if there is anything they do not understand. Consider if your patient may need help at home or a home care nurse to provide follow-up for further care or teaching. You will need a doctor’s order, but what better way to help your patient make the adjustment home. Again, remember your patient is unique and has their own individual needs. As you address their physical needs, be the advocate, be the teacher and be someone who they will remember cared about them!