Recognizing the challenges inherent in educating members of the community about health promotion, illness and disease self-management, RNs think outside the box to deliver flexible programs targeting specific populations. Jane Schaefer, MSN, RN, director of referral systems for Memorial Hospital of South Bend, IN, described the nurse-driven model of care used at the facility's 10-year-old Health Discovery Center. "It was originally a walk-in center to provide access to licensed healthcare providers for educational purposes, and we've since expanded to include bedside teaching as well," she said. "We have a screening area, can make individual appointments with RN educators and continue to provide walk-in services as well."
Partners in Nursing
The bedside teaching program is known as Partners in Nursing. "Inpatient nurses don't always have the time to do in-depth patient and family education," Schaefer acknowledged. "And patients who are ill or newly diagnosed with a health issue aren't necessarily ready to receive a laundry list of everything they need to do. With shorter lengths of stay, discharge teaching can be rushed, and we are glad we're there to fill in the gaps."
Kree McMullen, BSN, RN, nurse educator at the Health Discovery Center, talked about the wealth of assistance she can provide. "I've worked with patients who were admitted to the hospital with a serious medical problem and told to quit smoking," she said. "I can take a packet of information to the patient's bedside, sit down and discuss the benefits of smoking cessation, share information about products to stop smoking and tell him about smoking cessation classes offered through the Health Discovery Center."
Nurses at the center have developed teaching packets for topics such as weight management, diabetes self-management, smoking cessation, osteoporosis and high cholesterol. "I can take the written information to the patients' rooms and leave it for them to review at their leisure," McMullen noted. "Sometimes, it's just one visit, but often patients will ask about continuing their education on the topic. So I may provide an initial session on weight management, and then refer the individual to five additional sessions available through our center. I'd say about 30 percent of patients do return for more information. I can also offer an RN appointment to individualize information about a specific topic."
Nurses at the Health Discovery Center collaborate with their colleagues in the nurse call center. "We can direct patients to the call center nurses for a physician referral, triage or health information over the phone," said McMullen. "Sometimes, the call center staff will refer people to us so they can obtain written information, view our videos or take advantage of our free computer access."
A Thousand Questions
Jennifer Smith, BSN, RN, manager of the ASK-A-NURSE Resource Center at Shawnee Mission Medical Center, Shawnee Mission, KS, described the role call center nurses play in telephone triage, health education, physician referral and appointment scheduling. "We do a little bit of everything, talking with people across the spectrum of age, disease and disability," she said. "We're celebrating our 25th anniversary next year, and there isn't a question we haven't received over the years."
In addition to answering questions and providing health education over the phone, nurses can direct callers to an internal health information library or recommend authoritative health sites sponsored by organizations such as the CDC, NIH or local health departments. "We can send out information by mail as well," said Smith.
Why staff a call center with registered nurses? "For one thing, we answer questions across all age groups and in all areas of health, so it's important to have a really broad knowledge base," said Smith. "RNs also have the critical-thinking and problem-solving skills to talk with people over the phone and make sound decisions without being able to see or touch the person."
The nurses at the ASK-A-NURSE call center are an integral part of the fabric of the communities they serve. "We're hearing from second and third generations, with women passing our phone number on to their own daughters when they have children," said Smith. "Word of mouth has been fantastic, and one person told me, 'It's kind of like McDonald's-you've always been around.'"
Marcy Coppernoll, MS, BS, RN, thoroughly enjoys her role as curriculum director at the Hult Center for Health Education, Peoria, IL, a not-for-profit organization established to supplement the health education efforts of Illinois schools, families, civic groups, youth organizations, social agencies, businesses, churches and healthcare institutions. "[Our goal] is to provide education to individuals of all ages, with an emphasis on health promotion versus health restoration or maintenance," she said. "We have five teaching theaters with audiovisual equipment and exhibits here at the center, as well as an auditorium, or we can go out into the community to present programs."
Patti Bash, BSN, RN, who currently serves as an instructor, was instrumental in the development of the Hult Center 20 years ago. "We've found a nursing background is ideal, because you can't do nursing care without teaching," Coppernoll noted. "Nursing students from area schools come in to observe our classes as part of their community health rotation."
The Hult Center is part of a group of health education centers that includes one in Fort Wayne, IN, one in Indianapolis and two in Chicago. Presentations are tailored for each population. "For seniors, we might present information about medication management, heart disease or strokes," Coppernoll explained. "We sponsor a health fair for seniors, providing a location for agencies that serve older adults to set up booths with information about what's available in the community. We'll do lipid screening, metabolic profiles and other blood work. We also go to senior meal sites, churches, retirement groups and a foster grandparent organization."
"Much of our teaching is visual, and we do a lot of what I call edutainment to make health education fun for children," said Coppernoll. "Some popular topics for school-based programs include substance abuse prevention and puberty issues. We'll work closely with teachers and design specific programs to meet the needs and developmental levels of special needs groups. We typically include a lot of hands-on activities to make the session multisensory."
Sandy Keefe is a frequent contributor to ADVANCE.