After so many years, I have come to the conclusion that we all have “hot button” issues. But sometimes they still can take you by surprise, particularly when they represent looking at the world in a different way.
I was talking with a teaching colleague recently and the subject of health literacy came up. We can think of health literacy as our ability to understand the health care system and health information that might come from a physician, nurse or pharmacist. When we teach our future physicians, nurses or pharmacists to work with patients it is not uncommon to emphasize that patients do not know everything that we know. It is appropriate to speak to people at a level that they can understand.
So here comes the hot button issue:
your health care professional is doing their best to communicate with you, but you feel that they are “talking down” to you. And while profiling individuals may be illegal in the law enforcement setting, it happens all the time in the healthcare setting as we try to balance effective communications without “talking down” to patients.
My colleague is an educated woman, though not a health professional. She does not like the idea that we train pharmacists to communicate with patients at about the fifth grade level. “But wait a minute…”, I urged; you have to understand the other side of the story.
Almost every conceivable mistake has happened at some time in the health care setting.
Learning of these misadventures and adapting practice is part of being a good health professional.
Amoxicillin suspension is a common antibiotic that most kids will take by mouth at some time during their childhood, often for middle ear infection. One of our medical residents was telling of a patient who returned after the ten day course of treatment with a child who had an ear infection in the opposite ear. When the mom asked if she should start pouring the medicine into that ear, we realized that not everyone understands that medicine for ears does not have to go in the ear. This changed my practice; I always label prescriptions with the route of administration – by mouth, in the ear, or whatever – to avoid a similar misadventure.
After my oldest son was born, his belly button continued to bleed for some time after his scab fell off; nothing dramatic, but a cause for concern. Of even more concern to me was when my wife told me that the pediatrician had him and was going to “cauterize” it. Now, cauterize means to burn something, so I had visions of little Huck’s belly button being attacked with a hot iron; I had seen bleeding stopped like that in old pirate movies. Of course, that was not what it was. My son’s navel was touched with a silver nitrate stick, which painlessly coagulates proteins and stopped the bleeding. I learned that if something sounds too bad to be true, you probably need to learn more about it before you worry.
I am always sensitive to patients who express strong feelings against something that appears to be trivial; there is often some underlying misunderstanding.
We once had an older patient in my old Revco pharmacy loudly refuse our younger pharmacy technicians when asked to complete our patient registration forms. I offered to walk him through it and type his answers into our computer system. He thanked me afterwards and told me was embarrassed that he could not read.
Good health care professionals are constantly “profiling” you to provide information at just the right level for you.
Help us out by letting us know that you understand or by asking questions to clarify.
Poor understanding of the health care system and health information can lead to some interesting and humorous stories, but we’d rather live the mundane life of having all medications taken as intended, all procedures comfortably understood and all patients helped and respected.
So give your physician, nurse or pharmacist a chance to hone their communications skills by talking about your health and your medicines. It’s a great chance for you to learn more about your health and for us to learn more about our patients.
Take good care of yourself.
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