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Medical-Surgical Nursing

5.3 Ethical Patient Education

Medical-Surgical Nursing5.3 Ethical Patient Education

Learning Objectives

By the end of this section, you will be able to:

  • Describe the ethics of providing patient education
  • Discuss the benefits of focusing on ethics in patient education

Personal beliefs can affect how nurses approach patient education, especially when a nurse does not believe in or agree with specific treatments or health-care choices. Examples of this may include specific types of treatments or surgeries, medications, or certain vaccines. Despite personal beliefs, nurses have a responsibility to present factual, evidenced-based education to patients that is in alignment with current standards of care and practice. Education should be based on what a treatment does, and not what the nurse believes.

The use of systematic patient education improves the likelihood that patients can meet their specific health-care needs. Despite a patient’s willingness to learn, the nurse has a responsibility to present information that will motivate the person to recognize the necessity to learn. Health education is vitally important to nursing care because it promotes the ability of patients and families to behave in ways that are conducive to optimal self-care.

How Nurses Educate Patients

The various learning experiences designed to promote behaviors that facilitate health are considered health education. It is essential to promote optimal patient outcomes. The function of teaching in nursing is included in state practice acts and the ANA Code of Ethics for Nurses. Nursing care is directed toward promoting, maintaining, and restoring health; preventing illness; and assisting people to adapt to the residual effects of illness. This mindset should result in making every encounter with a health-care consumer an opportunity for education.

Nurses should provide education that is simple, patient centered and multimodal (i.e., using a variety of methods) to ensure the health literacy of patients and caregivers is met. Health literacy, as defined by the Centers for Disease Control and Prevention (CDC), is “the degree to which individuals have the ability to find, understand, and use information to inform health-related decisions and actions” (CDC, 2023b, para 2).

It is also important to be mindful that patients can feel overwhelmed by receiving too much information, making it necessary to keep the process simple. To ensure patient education is easily understood:

  • Do not go too in-depth into a disease process with a newly diagnosed patient.
  • Provide written information to enable the patient to review it later.
  • Provide the patient education in the patient’s preferred language, when possible.
  • Speak slowly and relay the instructions clearly.
  • Use layman terms and visual aids.

To advance patient education:

  • Begin patient education with each encounter starting at admission.
  • Ask the patient how they would explain their disease (step-by-step teach-back technique).
  • Be mindful of the patient’s limitations and strengths.
  • Determine the patient’s learning style.
  • Determine what the patient already knows and correct any misinformation.
  • Include the family in all patient education as much as possible, using the same suggestions.
  • Provide information about signs and symptoms of the patient’s condition that may warrant immediate attention.
  • Stimulate the patient’s interest.
  • Take advantage of educational technology.
  • Use return demonstration, involving the patient from the very first treatment.

Providing Ethical Education

It is important to maintain an ethical mindset when providing patient education, to ensure the teaching focuses on what a treatment does and not what the nurse believes. Effective health education promotes individual and community wellness and is directly related to positive patient care outcomes. Teaching is an integral tool used by nurses to help patients and families adopt effective health behaviors and alter lifestyle patterns that create a predisposition to health risks. Providing ethical health education includes ensuring the education materials:

  • Are accurate and up to date
  • Consider the psychosocial situation of the patient
  • Include cultural factors, religious beliefs, and values
  • Take health disparities into consideration

Providing Education Ethically

To provide education in an ethical manner, the teaching cannot be biased. Just as every patient has a right to equitable patient-centered care, every individual has a right to the same patient education, regardless of age, gender, or socioeconomic status, that is aligned with a patient’s beliefs and values.

Ethical development of patient education includes but is not limited to:

  • Being mindful of cultural and religious differences
  • Being mindful of the patient’s communication barriers, especially sensory impairment such as sight or hearing, as well as cognitive disabilities
  • Considering the health disparities of each patient
  • Providing continuous, compassionate education, especially for patients who have a limited understanding of how behavior affects health
  • Providing educational content in a variety of forms to capture patients’ different learning styles
  • Providing educational materials in the patient’s native language with their health literacy in mind
  • Writing down important information so the patient can take it after discharge

The preventable differences that underserved populations experience related to disease, injury, or violence that can negatively impact health are considered health disparities (CDC, 2023a). Health disparities result from multiple factors, which include poverty, environmental threats, inadequate access to health care, individual and behavioral factors, and educational inequalities. Nurses should be sure that any educational material is developed with the patient’s health disparities in mind.

Benefits of Ethical Patient Education

Patient education that considers health disparities, health equity, cultural and religious differences, and health literacy is a win-win for the patient and the health-care team. Benefits of ethical patient education include

  • Changing communities with each health consumer encounter
  • Creating a stronger patient-nurse trust relationship
  • Decreasing re-hospitalizations
  • Helping patients manage their health more effectively to improve outcomes
  • Improving health literacy
  • Increasing the patient’s ability to understand how behavior choices affect health
  • Meeting consumers’ expectations for comprehensive health information
  • Motivating the patient’s desire to learn
  • Providing motivation to choose a healthier lifestyle
  • Reducing health disparities while improving health equity

Real RN Stories

Nurse: Carolyn
 Years in Practice: 15
 Clinical Setting: Hospital

Carolyn, a nurse who has maintained the practice of compassionate care during her 15 years of nursing, practices mindfulness related to each patient’s different learning styles. Carolyn is vigilant in providing educational material that is appropriate for each patient’s learning style, which helps increase the amount of information the patient can absorb and use in their decision making.

Mr. Smith is a 70-year-old patient with congestive heart failure and chronic obstructive pulmonary disease who is preparing for discharge. Carolyn observed during the course of his hospitalization that Mr. Smith is a visual learner as well as a kinesthetic/tactile learner. To address Mr. Smith’s visual style of learning, Carolyn teaches Mr. Smith disease management techniques daily so he can see and observe the techniques and decisions Carolyn uses in the daily in-patient care. Carolyn also provides written instructions, pictures, and diagrams for Mr. Smith to reference once he is home.

Carolyn sees that Mr. Smith learns best when he is physically engaged during the learning process. The physical engagement helps distract Mr. Smith from his difficulty sitting still, allowing him to learn through hands-on demonstrations and teaching. To address Mr. Smith’s kinesthetic/tactile learning style, Carolyn walks Mr. Smith through using his metered-dose inhaler, setting up his continuous positive airway pressure (CPAP) machine, and administering breathing treatments. Carolyn and Mr. Smith work well together with the hands-on education and return demonstrations, or “teach-back” what they have learned.

Carolyn also has a second patient ready for discharge. Ms. Johnson is a 65-year-old patient with insulin-dependent diabetes. Carolyn observes that Ms. Johnson is an auditory learner as well as a reading and writing type of learner. Carolyn is mindful to talk through her daily routines and care during her time with Ms. Johnson, knowing Ms. Johnson will retain more beneficial information to ensure an optimal long-term outcome after discharge. Carolyn reinforces medication information by saying it out loud each time she administers Ms. Johnson’s insulin to ensure Ms. Johnson will recall how to use her new insulin pen. Closer to the patient’s discharge date, Carolyn begins having Ms. Johnson use return demonstrations that help reinforce her dietary and medication needs as well as lifestyle choices.

With Ms. Johnson also being a reading and writing type of learner, Carolyn helps Ms. Johnson write down the important information. The process of writing and reading the instructions reinforces the educational materials for Ms. Johnson and will also serve as a reference upon her return home.

Carolyn loves being a nurse and helping people. Carolyn’s efforts to ensure her patients are equipped with the education to meet their needs have established trust, provided peace of mind for her patients and families, and will ensure better outcomes for the patients upon their arrival home. Taking time to help patients understand and manage their disease equips them to make healthier lifestyle choices to promote better outcomes. This is an important part of the foundation of how and why nurses have become the most trusted profession in the United States.

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