As one of the foremost theorists, Dorothea Orem (1914-2007) is a familiar name to most nurses. Orem’s Self-Care Theory presumed that people were capable of being self-reliant and responsible for their own care, as well as the care of others in their family who needed care. She firmly believed nursing was a form of action-interaction between two or more persons, and a person’s knowledge of potential health problems was necessary to promote self-care behaviors.
According to Orem, the goal of nursing was to render the patient capable of meeting self-care needs, a process that often includes patient teaching. Whether nurses are teaching a new mother how to care for the neonate or teaching a new diabetic about insulin management and life-style changes, Orem’s principles are still applicable. Using Self-Care Theory as an organizing framework, several suggestions can assist in the promotion of quality outcomes:
Be culturally aware. For some cultures, illness is a family event. For example, a nurse might teach many extended members if the patient is the matriarch of a Hispanic family. Do not alienate the family, as they may be great allies in maintaining and promoting self-care behaviors.
Presume that patients can be responsible for their care. If the patient has decisional capacity, allow the patient to participate in the learning process. Use principles of adult learning, and build in demonstration or teach-back methods.
Provide for optimal learning conditions. Do not try to teach a patient while they are sleepy, hungry or in pain. Provide a quiet and private place. Silence your phone, and give the patient your undivided attention.
Assess the patient’s existing knowledge. Never make assumptions. For example, you may have a patient with no formal education, from a lower socio-economic group who has taken ownership of their disease. On their own, the patient has done some introductory research and has a basic understanding. Assuming that they are “ignorant” will not build the nurse-patient alliance necessary for further successful teaching.
As part of their daily routine, most nurses educate patients – from medications and procedures to home-care and symptom management. Nurses can make the difference, helping patients and their families understand a complex healthcare situation. Often, this teaching takes the form of a handout or brochure, in order to reinforce the teaching once the patient returns home. To foster effective interventions, read these tips:
- Determine your goal. Will the patient read the handout once and throw away or will the patient use it daily in a log format? Is the goal to comprehend a one-time procedure or a complex disease with lifestyle changes?
- Know your reader. Pay attention to educational background, literacy level, cultural biases and visual impairments.
- Watch content. Make sure the content is accurate, and up-to-date. It is very frustrating for a patient to receive community contact numbers that are no longer in service.0
- Watch the medical jargon. Put terms in every-day language: “pill” instead of “medication”; “cream” instead of “ointment”; “use” instead of “utilize”.
- Stay organized. Put the most important information first; do not use all capital letters or all italics as it is harder to read; and use a font size that is elder-friendly. Use headings and subheadings to group information.
Additional information to assist nurses in developing and evaluating educational handouts for patients/families are available from the Center for Professional Practice of Nursing at the UC Davis Health System.
Effective teaching has a significant impact on patient health and safety, as well as hospital readmission rates, which affects a hospital’s bottom line. Educating patients effectively can also improve your satisfaction as a nurse because you know you impacted someone’s quality of life.