The internet practically places patients in a virtual medical school that’s connected to their fingertips. And it’s complete with thorough research tools, common prescription interactions, detailed medical Q&As – and live chat rooms with real nurses.
Now, patients usually have a lot on their mind when faced with an MS diagnosis, or when their loved one exhibits early signs of Alzheimer’s. The question is, do patients receive better care when they do a little homework before they see you – the well-educated nurse?
Many healthcare professionals say, yes.
When patients are “fully prepared” at the time of their visit, many will have better health outcomes, said Nancy B. Finn, author of E-Patients Live Longer, a book that explores E-health and E-patients, a concept that includes more medically savvy patients who use of the internet applications like email and applied telemedicine.
Compared to 15 or 20 years ago when the layperson had limited medical information about rare diseases and new drugs, patients may not have even known which questions were relevant after they received a breast cancer diagnosis, for example.
But now, experts say, WebMD-educated patients practically walk in the examination room wearing a white coat, surgical gloves and a pair of white clogs to match.
Caring for the Well-Informed Patient
So what does it take to work side-by-side your medically savvy patients? For starters, a good set of ears.
“With patients who are more informed and taking more charge of their health, nurses need to be sure that they take the time to listen and engage with the patient on equal ground,” said Finn.
Finn said e-patients, those who arm themselves with medical knowledge become “active participants” in their own health and healing.
“It will make the patient more collaborative in their healthcare,” she said.
Everyone knows the fast-paced nature of nursing jobs.
So if it seems like you have little time as it is, and you’re not that thrilled about epic-length medical conversations or debates with patients who ask you detailed questions they take away from the fine print of new drug treatments, you’re not alone.
Eva Fabian is the vice president of nursing at Workmen’s Circle MultiCare Center, nonprofit facility in Bronx, NY, that serves 500 plus patients with long-term, short-term or subacute (rehabilitation) care needs.
Fabian is well aware of the challenges nurses face when working with smart patients who may seem like RNs and MDs themselves.
“It’s common that patients come in well informed. They Google their condition and, they even print it out and show it to me,” she said, adding, “Sometimes they challenge the medications prescribed.”
While many patients or family members seem to know all the side effects and potential health risks from a newly prescribed medicine, Fabian said it’s important to remember, they simply want their loved one to get the best care.
When you feel challenged by the well-informed patient, Fabian said you can disarm the situation creating dialogue between the patient and the rest of the healthcare team.
“The worst way to handle it is to say, ‘I didn’t know about that,'” Fabian cautioned nurses. “What I would suggest is to always refer them to the physician, and tell the family, ‘I will communicate your concerns with the doctor.”’ Also, offer to call the family back as a follow-up, she added.
When patients or family members take that medical knowledge and become aggressive, keep your cool with artful problem solving.
So says Carole Kenner, PhD, RNC-NIC, FAAN, from Northeastern University, Bouve College of Health Sciences School of Nursing, Boston.
Suggest a family meeting, she recomends. That way everyone hears the questions and decisions together.
“You can try to mediate them and their aggressiveness,” she said. [You could say] ‘I’m just trying to understand,’ and then try to take it to the next level. It’s the skill of negotiation.”
Instant Answers
With a simple internet connection, telemedicine allows a nurse into the patient’s home for quick, easy follow up care.
“Virtual consults are being used in rural areas where nurses are watching trends and intervening [with patients],” said Kenner. “Asthma, hypertensive and diabetic, patients would send their data over the Internet and then nurses would watch and make follow up calls.”
Want another quick info-tool? How about patients who simply whip out their mobile device? Then download “Mole App,” for example, take a picture of the suspicious lesion and send it to off for analysis. That’s quick.
Anyone dealing with forgetful patients? Consider how many times family members forget to ask important questions, like how frequently their elderly parent should take a new medicine? With email communications between nurse and patient growing in popularity, now these questions are quickly answered in the same day, Finn said.
Not enough time for email? Try to be patient with yourself as you take on more responsibilities. “You just have to set aside some time to check those emails. Usually a team is also checking the email,” said Kenner.
With improved communications like email, Finn said it directly affects patient care. “If there’s ongoing communication with a patient with a chronic disease [like asthma, diabetes] monitoring the disease can be handled more effectively and more quickly,” she said.
Less is More
A final note. Saying good-bye to paper charting and records may be something you learn to love. Electronic medical records save time and decrease unnecessary tests.
What’s more, less will be missed, Finn added, noting that in a study conducted by the Agency for Healthcare Research and Quality, clinicians reported that in a representative sample of more than 1,500 clinical visits, important information was missing in 13.6% of the cases, Fin added.
“When you have the info at the point of care, and it’s shared among the team, they don’t have to reorder tests because something is accidentally missing,” she said.
Elise Oberliesen
is a freelance writer for ADVANCE.
