It turns out the physician who
burst into Dad’s hospital room for the late night exam and diagnostic interrogation
did a better job than I gave him credit for, at least clinically. (See yesterday’s
blog). He held a discussion with other family members at discharge, which I
missed. His sketch of the “explosion” in Dad’s neck made sense to my sister-in-law,
an RN. From a health literacy standpoint, it is likely the medical background
knowledge required to understand his sketch is so much a part of his daily
conversations that it seems to him like something everyone knows – but more
likely it’s something only every medical professional knows –not us PhDs and
lawyers - a case of clinician’shyper health literacy. While this physician had not read
Dad’s chart, he did read the x-ray, noted the possible problem, and checked it
out both on rounds and at discharge. At discharge, he confirmed by examination
that Dad’s neck was not fractured and tried again to explain the concern. So he is a good thorough caring clinician, who needs to polish up his
bedside manner and communication skills – the clinician’s side of health
literacy. My brother, a firefighter and EMT, showed exceptional health literacy
by requesting a copy of the x-ray to take to Dad’s follow up appointment with
his personal physician. The doctor provided it on disk. Kudos to them both. Back in the ER
The day after Dad returned home
from the hospital, he seemed to be improving. Then quite suddenly, he felt too
weak to get up out of his chair. His vision blurred. His words slurred. Mom’s actions in response demonstrated her high health literacy. She went to the
refrigerator where she had posted the FAST Stroke Test. Dad’s slurred
speech and his inability to “put his thoughts in his mouth” led her to call
911. Back in the ER, doctors determined that it was not a stroke, but lack of
food (he can’t chew due to abrasions in his mouth) and anemia from blood loss. Dad
was stabilized and is home again. Mom is dressing his wounds 3 times a day,
reading up on nutritional supplements, and thinking she might qualify for a
nursing license. Health Literacy – beyond
understanding information
This experience illustrates that health literacy is not
something you have or you don’t. It is a learned skill set that develops over
time with need, experience and support. Health literacy can only improve
outcomes when one acts on information. And actions, how a person actually uses information for health, are good
indicators of that person’s health literacy. “Knowing is not enough, we must apply. Willing is
not enough, we must do.” Goethe
Reference: More on stroke http://www.webmd.com/stroke/slideshow-stroke-overview Picture from WebMD Slideshow: A Visual Guide to Understanding Stroke |