09 Oct Not a Good Time: When the patient is not mentally ready for discharge teaching
A woman has just given birth. Physiologically, not figuratively, her body has run a marathon. She has ‘enjoyed’ childbirth. During her pregnancy perhaps she has had difficulty sleeping for several months because of any combination of a dozen reasons: back pain, reflux, weight gain, headache, joint aches, reflux (I was told to write that one twice). She is now diligently waking every 2-3 hours to breast feed her newborn. I haven’t mentioned the mental fog that this lack of sleep and metabolic merry-go-found has engulfed the mother in.
In North Carolina alone, this scenario happened over 300 times today. It happened over 300 times yesterday. The same will happen tomorrow.
Now enter a doctor who wants to give you some verbal instructions on infant care, or car seats, or stooling patterns in an infant, or sleep patterns, or jaundice. It’s ok though, the doctor is going to give you some papers to read that contain all of this information written so simply that a sixth grader could understand it (read-‘it is several pages of paper’).
The doctor leaves.
Do you even remember her name? It’s on the paper.
The doctor has dedicated years of her life to care for you and/or your infant, but frequently she doesn’t have the time she wants to spend with mom, or the tools to communicate this effectively. The odds are against her. She has clinic to get to, an EMR that is being constantly updated, the leadership committees, QI meetings- and then there are the phone calls.
Studies show that the patient is only going to pick only a fraction of the information that’s been communicated to her. Half of that is going to be remembered incorrectly.
She needs to hear it, read it, see it several times when it is more convenient for her, when she is more rested, when her mind is less fragmented. How can she learn these things? After all, learning something, really taking the information in, requires repetition, gradualness, and simplicity of communication in different formats catered to the patient.
Meeting this need is the goal of BeeWell.