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The Nurse as a Pedagogue: Shaking off the Manacles in Patient Education

Submitted by on August 31, 2015 – 1:24 AM

nurseCommunication plays a pivotal role in the deliverance of thoughts and perceptions to others, verbally or non verbally in an easy and clear way. Effective communication is critical countless times during the interaction of a nurse with her patients. Many a time, nurses face challenges in responding to patients in areas which are sensitive to talk about because of cultural context. We know that nursing is about caring and listening to patients and making an effort to improve their quality of life in all dimensions of health.


As Philip Authier quotes “Effective nursing communications is all about getting the right information to the right person in the right format at the right time in the right location — all in a way that is easily understandable”.  What if a nurse is good with rapport building but due to peer’s non command on the topic faces a challenge regaining the patient’s confidence?


I encountered a 38 year old lady, Gravida 2 Para 1+1. She had an ectopic pregnancy in previous history. I was working with a colleague and we found her facing difficulties in breast feeding her baby because she didn’t know about the proper technique of breast feeding and her baby was crying out of hunger. We both established a rapport with the patient. I was comfortable in addressing the topic of breast feeding and taught her with confidence but I saw that my colleague was hesitating due to which the patient felt uncomfortable too. Later, the unease of the patient led me to start from scratch, i.e., rapport building.


At the time of the incident, I had mixed feelings. On one side, I was relieved that I was able to initiate dialogue on sensitive subjects but on the other hand, my anxiety was at peak because of my partner’s hesitancy to address the problem at hand. I was also afraid concerning the patient’s ability to communicate with us in the same manner again. Concurrently I was relieved that the teaching part went successfully and helped the client in learning about breast feeding as the client was badly in need of guidance and had many misconceptions that required timely intervention.


Upon discussing it with my colleague and my own reflection, I found myself regretting that I didn’t ask my partner about her expertise and comfort. After analyzing the incident, it drew on me that communication greatly impacts the excellence of health education. More over, communication is fitted in everything“From obtaining the patient’s medical history to conveying a treatment plan, the physician’s relationship with his patient is built on effective communication” (Travaline, 2005).


First reason which assisted me in teaching was my comfort with the subject. Our cultural backgrounds influence our willingness to speak and the ability to communicate effectively and having a medical background, I have been indulged in many discussions at home regarding reproductive health. Whereas, if I ponder upon my colleague’s behavior; she lacked communication skills, and that hindered the imparting of knowledge to the patient. As literature states that  “Communication requires full understanding of behaviors associated with the sender and receiver and the possible barriers that are likely to exist, selecting a communication channel requires a complete understanding of the strengths, limitations and possible solutions related to each potential channel.” (Health education research 2008).


As a student nurse, such a situation can recur, so I drew out few options that could have changed the situation in a better way. As the main problem was the comfort in talking about the topic; I would assess my colleague’s ease with the topic and the command over the subject which we would deliver to the patient. After this we need to identify and assist the students who feel shy talking about or initiating such topics. I would help them when they teach and they can observe me while I communicate. This way their shyness would decrease and they will be more confident and comfortable in addressing the needs of patients effectively.


Hesitancy in discussing sensitive topics with elderly clients can also be solved if we discuss the content beforehand and rehearse with one another in terms of the style and flow of teaching. Moreover, building rapport, initiating the conversation with some other health aspect and then teaching about breast feeding can also be another way out. Lastly, it would be beneficial to have a discussion with my colleague regarding the teaching aspects prior to patient interaction and conclude by addressing sensitive topics myself so that she learns how to converse over such themes. But from now, I would not let such a situation to recur.


To conclude, nurses who are competent in certain areas should help others in establishing rapport and in imparting necessary information regarding health to patients as some nurses might feel reluctant while dealing with patients on sensitive issues but a nurse should not make this a barrier  because that would hinder the continuum of  care.



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