When is education not a good thing for all patients?

One of my favorite doctors recently told me that not only does she recommend my childbirth classes to her patients, she also decides in some cases that childbirth education is not a good idea for some of her other patients–which led me to the question: When is education not a good thing for all patients?

As a childbirth educator and a nurse on the labor and delivery floor, I encounter both types of patient: the educated and the clueless. And guess what? The educated patient seems to have a more positive birth experience. They understand their options, they participate more fully in informed consent, and they advocate better for themselves. Not to mention they feel more comfortable with the nurses and docs, their bodies and the labor process, and yes, their new babies!

Conversely, my patients who enter the childbirth process without any knowledge have more fear about the process, are often misinformed by all the crap floating around the internet (yes, there is good stuff–but there is a fair share of junk as well) and I spend most of my time educating them on the basics when I could be nursing them, educating them beyond the basics and taking care of their physical needs.

For example, the learned laboring woman understands when I say, “It’s time to check your cervix.” The mom who has never experienced a childbirth class, and hasn’t done any study on her own, has no idea what a cervix is and why I would need to check it. Imagine her shock when I, and not the doctor, come at her with a lubricated glove while she is the worst pain of her life. Not fun for either one of us.

Yet doctors need to be on board with us nurses about patient education–they are the missing piece. One doc I know offers his patients a “5 minute childbirth class” during a 10 min. prenatal visit. In those five minutes he tells them when to call the doctor in labor, how to valet park at the hospital, and then tells them to get the epidural as soon as possible. You can imagine how many blanks I have to fill in after such a “class.”

The thing is that every patient is entitled to know what is happening to their bodies, should be informed about their plan of care and educated on their options. Whether that happens at the bedside, in a formalized class or in the docs office is more specific to specialty.

But the reality is that this isn’t always a priority for hospitals and the physicians we encounter. It takes the really zealous bedside nurse or nurse educator to stick her neck out and say, “Hey doc, ALL your patients need education.” And then we have to do the work and take the time to teach when the patients come our way. For our patient’s sake we should all be insistent about this vital part of our nursing care.