1. Rodts, Mary Faut

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Making sure that our patients understand their medical condition is something that nurses claim as one of their key patient advocacy roles. We believe it is important for our patients and families to fully comprehend the diagnosis, tests, procedures, risks, and concerns. We like to say it is our territory and we do it well. Or do we?

FIGURE. Mary Faut Ro... - Click to enlarge in new windowFIGURE. Mary Faut Rodts, MS, MSA, CNP, ONC, FAAN, EDITOR

We know that a patient who has a complete understanding of what his or her diagnosis is and what needs to be done to further address it will be able to more fully participate in his or her care. The decisions that a patient or family must make regarding healthcare require knowledge. Carolyn Cutilli in her article Health Literacy opened my eyes to the issues related to what patients are capable of understanding.


How many of us have been in the situation where we read office records of the patient's primary physician or the specialist who has seen the patient in the past. You see statements such as, "The entire procedure was explained to the patient and his family. They understand everything and wish to proceed." You expect to enter the patient's examination room to have a patient who fully understands what is ahead, but instead you find a distraught family who says they have no idea what is going on. This happens more often than we think, and now we know why.


Taking the information down to the level of the patient is a critical first step in helping the patient understand his or her unique situation. Yet, as Cutilli points out, 25% of the American adult population (44 million people) are illiterate, with another 50 million people marginally literate. When relating this information to complex health information and education, the Institute of Medicine believes that approximately 90 million American adults would not be able to use the U.S. healthcare system. Does this shock you as it shocked me? From the very basics of understanding a blood test to the difficult aspect of accessing care in a complex health system, this may be well beyond the reach of more than 50% of the U.S. adult population.


Patient education is one of the things that we as nurses believe we can do better than others. We like to take the time to talk to our patients and educate them. With that in mind, we need to look at the issues of patient education, the first being health literacy. During the next few months, you will see various articles on Patient Education. In this issue, we begin with Carolyn Cutilli's article on Health Literacy. I believe we should each read it and begin to be aware of our patient's limitations. We need to look critically at the printed materials we hand to our patients, as well as how we teach our patients. Making sure that what we are saying to our patients is understood is critical. We will begin to explore this concern in this issue and future issues of Orthopaedic Nursing.