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Work with staff to educate patients
Terry Chase, ND, RN, patient and family education program coordinator at Craig Hospital in Englewood, CO, received her nursing degree in 1996. She had been teaching in public schools for ten years, but her experience as a patient following a spinal cord injury prompted her to change careers.
"I felt that I could make some contribution to the field of nursing around patient education," says Chase.
She has been in her position at Craig Hospital, an 80-bed model rehabilitation center for patients with brain and spinal cord injuries, for eight years. Before Chase started at Craig, she earned a master’s degree in exercise physiology and a doctorate of nursing (ND). She is currently working on a master’s degree in spiritual psychology.
Patient education is part of nursing administration at Craig Hospital. Chase reports to the vice president of patient care services. She is responsible for the overall education program and must make sure it is compliant with the standards set by the Joint Commission on Accreditation of Healthcare Organizations.
Chase also is responsible for ensuring that staff members have the resources they need to do their jobs, such as written materials, videos, or classes. Chase revises and updates written materials and most recently rewrote the handbook for patients with spinal cord injuries. She helps create new videos by writing the scripts and directing the filming.
"Basically, I see myself as the support to the staff, who are the front-line patient educators," says Chase.
Teaching is part of her job at Craig Hospital, and she can often be found in the classroom as well as working one-on-one with patients and their family members to reinforce the teaching that other staff members have provided.
In the classroom, Chase teaches some of the curriculum on her own, but she also partners with other disciplines at times. For example, she teaches about medications with the pharmacist, and partners with the psychologist to teach coping skills.
Patients are not always physically, mentally, or emotionally ready to learn when they arrive at Craig Hospital. At the same time, there is a limited amount of time to complete the patient’s rehabilitation. Therefore, educators must begin giving the lessons as soon as possible and deal with barriers to education as they arise.
"As health care has changed, we are getting people earlier and earlier. We have had people within three days of their injury," says Chase.
In a recent interview with Patient Education Management, Chase discussed her philosophy on patient education, the challenges she has met, and the skills she has developed that help her do her job well.
Q: What is your best success story?
A: "In this hospital, where I was a patient, I have been able to create a patient education program," she says. "No one was really directing it, so I have been able to move our patient education program toward excellence, always looking for ways to improve, expand, and be innovative. I have integrated our patient education classes into the therapy schedule, and therapists now come to me to get their patients into classes."
The institution has three series of classes. The first is basic education for patients with a spinal cord injury or a spinal cord injury combined with a brain injury, which includes instruction on bladder, bowel, and skin care; medications; stress and coping; and air travel.
A second series is called "tetra" topics, which is short for tetraplegia. These are interdisciplinary classes designed for patients with high-level spinal cord injuries. A third series of classes focuses on re-entry issues for spinal cord injury patients, such as getting a job and sexuality.
"The classes for brain injury patients are a work in progress," Chase says. "It is difficult to determine exactly what to teach when learning is so individual and based upon the extent of the injury. "
Q: What is your area of strength?
A: "I have good organizational skills for project planning. In addition, my gift is teaching. I really brought a lot of experiential education components to our program.
"From a personal standpoint, I have a spinal cord injury and have been a patient here. I have insight into what is needed in a program, and I can talk to the patients from that perspective."
Q: What lesson did you learn the hard way?
A: "That I needed to form relationships with other professionals at Craig Hospital so that we were working toward the same goal, and I was not going against them but working with them.
"I had to build rapport with other departments, letting them know that I was reinforcing what they were doing . . . that working with me would be beneficial and would reinforce what they are doing with their patients as opposed to them giving up their rehabilitation time to send their patients to class."
Q: What is your weakest link or greatest challenge?
A: "The greatest challenge for me is to work at the same pace as that of the organization. I want to be more innovative, and I have to temper that and wait for things to evolve so I am more in pace with the organization’s ability to grow."
Q: What is your vision for patient education for the future?
A: "I would like to see health care providers develop skills that would make them excellent educators. We have the content for teaching, and we know what will keep people healthy. But we fall short in health care because we can’t get the message across very well.
"I have been developing staff inservices and training around communication, listening skills, and teaching skills, as well as on how to be more caring educators.
"In order for patients to learn, it is important for health care workers to spend time with them even though it is easier to show a video. Patients really want someone to be interested in them and have personal contact. That makes a big difference."
Q: What have you done differently since your last JCAHO visit?
A: "We are trying to put our patient education documentation form into electronic format. We know the form is good because the Joint Commission put it in their book of examples, the Joint Commission Guide to Patient Education. Also, I am working on a way to document the kind of patient education we are doing around pain management."
Pain management is a large factor in a patient’s education and recovery at Craig Hospital, where patients often have multiple injuries. For example, a spinal cord patient might have fractured ribs, and this could slow his or her rehabilitation progress because upper-body strength is important for recovery.
Q: When trying to create and implement a new form, patient education materials, or program, where do you go to get information and ideas?
A: "I do look to the Joint Commission for examples, but I also belong to a patient education listserv, so I collect information off that. If I see an example of something that I think I will be able to use in the future, I print it off and put it in a file."
For more information about patient education at Craig Hospital, contact: