My son Matthew is 4 years old. He loves police cars, fire trucks and ambulances and he loves to point them out and talk about them whenever we see them, which in Philadelphia is A LOT.
Recently he started telling me that the ambulance picks up people with “sick feet” and takes them to the ‘hop-sital’ to get better. I’m not sure what he means when he says “sick feet,” but I think it’s a reinterpretation of something he has learned from a Dr. Seuss book. Since he is so consistent in his application of “sick feet,” I go with it.
We talk about people with sick feet and well feet. This discussion carried over into him finding some of my human body charts and wanting me to read them as a bedtime story, which is very hard to do. It’s hard to read an anatomical chart to a 4-year old because he doesn’t have the vocabulary to understand, and he doesn’t have the basic principles of medicine especially when we got to the chart on the body’s defenses and the endocrine system.
You see, my 4-year old son is health illiterate. He doesn’t “get” how the body works, and it seems like a waste of time trying to explain it to him.
Or is it that I don’t have the vocabulary to help him understand? The funny thing is, I found that I was struggling with breaking down complex concepts, but I was still using big nonsense words (at least to him). Despite my terrible bedtime storytelling of how the human body works, Matthew has insisted on reading these charts much to my frustration.
Finally, I turned to Google for some help and found right old Dr. Seuss. After all, he seems to be the one who started this; it seemed appropriate that he should be the one to come to the rescue. Dr. Seuss wrote this book called you’re “Inside Your Outside Machine.” This book explores what is inside your body and even includes a discussion of our body’s defense system (I still gloss quickly over the endocrine system).
This book was amazing and became the bridge for me to help Matthew start to connect the charts with some semblance of meaning, but also understand things like why he should cover his mouth when he coughs and sneezes.
Over a few weeks, we talked about how the red blood cells and the white blood cells are friends, and they like to play together. But if a germ comes into the body, the white blood cell has to attack it and eat it. At first, he didn’t think this was very nice, but then I told him that too many germs would cause you to have sick feet and you would have to go in the ambulance to the ‘hop-sital.’ Ahhh, our first real connection!
So why am I telling you this story?
Because one of the businesses I started as a NursePreneur was based on this concept. Stroke and neurological diseases are extremely complex medical conditions. It is very hard to break this down and explain to a patient everything they needed to know in their 10-minute discharge conversation.
I wanted to create a program for patients and caregivers to help them in the first 30 days after discharge. To feel safe with a lifeline and also to teach them the foundational blocks of what they needed to know moving forward about their condition.
Guess what—our patients are health illiterate too.
And that isn’t an insult to them, any more than it is to say that about my 4-year old. I have a physics illiteracy problem, and quite frankly I’m not ashamed of it.
The onus is on nursing to create solutions to this problem. Unfortunately, it can’t be done at work—you are not encouraged to spend a lot of time with your patients. Your job? Do as much as possible for as many people as possible, and document the crap out of it.
Think about it, if you spend two hours in a room with a patient going over complex discharge information, do you think your co-workers and nurse manager would say, ‘now there is a great nurse?’ No, they would say you are a slacker, not a team player, you don’t help out, and you were hiding in the room with the patient to avoid work.
This essence is the frustrations of nurses. Be a good nurse and get slammed, try not to care that you aren’t helping anyone and become disillusioned and feel like your part in healthcare is pointless.
But there is still something you can do that is a win-win solution. You can create a similar program as I mentioned above or there are a million variations of it. For any patient population or a medical condition, you can sell your knowledge as a package for patients to have when they leave the hospital.
You could easily package and sell your nursing knowledge broken into digestible pieces. The patient begins to connect action A with result B. You don’t have to be an advanced practice nurse to do this, but if you are, you could provide some additional services.
Something as simple as explaining how to order in a restaurant after heart failure; how to exercise after stroke; how to date after brain injury; how to say good-bye to family in terminal illness; coaching COPD patients. These are real issues that are important to real patients. And I’m guessing you don’t cover them in your discharge instructions. Where do patients go to get the info—probably Google. And you know as well as I do that the medical info out there is either so basic it’s almost insulting, or it’s so complicated it’s not for patients. There is no in-between.
Hence, the possibilities of what you could do or create as a NursePreneur are endless.
Health illiteracy is rampant in the U.S., but as far as I am concerned, that is not the problem. The problem is that as health care professionals, we don’t have the time to address the lack of understanding of our patients. We do our patients a massive disservice by assuming they can’t “get it” or pretending like they understand everything that has been told to them. We do the public an enormous disservice by not teaching them what they need to know about health and wellness in general.
If you believe the Johns Hopkins claim that medical errors are the third leading cause of death and admitted to the hospital is public health hazard #8, then we have a crapload of work to do and fast!
Health illiteracy shouldn’t be a problem that is blamed on patients, and it’s our problem as nurses and healthcare workers that we need to deal with. The consequences are just too high to ignore.